Hostname: page-component-76fb5796d-vvkck Total loading time: 0 Render date: 2024-04-29T03:56:23.866Z Has data issue: false hasContentIssue false
  • English
  • Français

Point-of-Care Ultrasound (PoCUS) and Its Potential to Advance Patient Care in Low-Resource Settings and Conflict Zones

Published online by Cambridge University Press:  22 June 2023

Elad Dana ,
A.D. Mahamat Nour ,
Gombako A. Kpa’Hanba  and
James S. Khan
Elad Dana*
Affiliation:
Department of Anesthesia, Intensive Care and Pain Medicine, Meir Medical Center, Kfar Saba, Israel, Affiliated to the Sackler School of Medicine, Tel Aviv University, Israel Department of Anesthesia and Pain Medicine, Mount Sinai Hospital, Toronto, ON, Canada
A.D. Mahamat Nour
Affiliation:
Department of Pediatric Surgery, Faculty of Health Sciences, University of N’Djamena, N’Djamena, Chad
Gombako A. Kpa’Hanba
Affiliation:
Department of Anesthesia and Intensive Care Medicine, Faculty of Health Sciences, University of N’Djamena, N’Djamena, Chad
James S. Khan
Affiliation:
Department of Anesthesia and Pain Medicine, Mount Sinai Hospital, Toronto, ON, Canada Department of Anesthesia, University of Toronto, Toronto, ON, Canada
*
Corresponding author: Elad Dana; Email: elad.dana@sinaihealth.ca.
Get access Rights & Permissions [Opens in a new window]

Abstract

Point-of-care ultrasound (PoCUS) is used by health care professionals of various specialties worldwide, with excellent results demonstrating significant potential to advance patient care. However, in low resource areas of the world, where other imaging modalities are scarce and the potential of handheld pocket-sized PoCUS devices with great versatility and increasing affordability seems most significant, its use is far from being widespread. In this report, our group of Chadian, Israeli, and Canadian physicians with experience in rural, military, and conflict zone medical aid, discusses the barriers to the implementation of PoCUS in low resource areas and offers potential solutions.

Keywords

conflict zonesemergency medicinelow-resource settingspoint-of-care ultrasound
Type
Commentary
Information
Disaster Medicine and Public Health Preparedness , Volume 17 , 2023 , e417
Copyright
© The Author(s), 2023. Published by Cambridge University Press on behalf of Society for Disaster Medicine and Public Health, Inc.

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Porcel, JM. Tuberculous pleural effusion. Lung. 2009;187(5):263-270.CrossRefGoogle ScholarPubMed
Atkinson, P, Bowra, J, Lambert, M, et al. International Federation for Emergency Medicine point of care ultrasound curriculum. CJEM. 2015;17(2):161-170.CrossRefGoogle ScholarPubMed
Moore, CL, Copel, JA. Point-of-care ultrasonography. N Engl J Med. 2011;364(8):749-757.CrossRefGoogle ScholarPubMed
Russell, FM, Herbert, A, Ferre, RM, et al. Development and implementation of a point of care ultrasound curriculum at a multi-site institution [Internet]. Ultrasound J. 2021;13. Accessed May 11, 2022. doi: 10.1186/s13089-021-00214-w Google Scholar
Tran, TT, Hlaing, M, Krause, M. Point-of-care ultrasound: applications in low- and middle-income countries. Curr Anesthesiol Rep. 2021;11(1):69-75. doi: 10.1007/s40140-020-00429-y CrossRefGoogle ScholarPubMed
Reynolds, TA, Amato, S, Kulola, I, et al. Impact of point-of-care ultrasound on clinical decision-making at an urban emergency department in Tanzania. PLoS One. 2018;13(4):e0194774.CrossRefGoogle ScholarPubMed
Byrne, M, Singleton, M, Kalagara, H, Haskins, SC. Perioperative point-of-care ultrasound. Adv Anesth. 2021;39:189-213.CrossRefGoogle ScholarPubMed
Naji, A, Chappidi, M, Ahmed, A, et al. Perioperative point-of-care ultrasound use by anesthesiologists. Cureus. 2021;13(5):e15217.Google ScholarPubMed
Sippel, S, Muruganandan, K, Levine, A, Shah, S. Review article: use of ultrasound in the developing world [Internet]. Int J Emerg Med. 2011;4. Accessed May 12, 2022. doi: 10.1186/1865-1380-4-72 CrossRefGoogle Scholar
Savell, SC, Baldwin, DS, Blessing, A, et al. Military use of point of care ultrasound (POCUS). J Spec Oper Med. 2021;21(2):35-42.CrossRefGoogle ScholarPubMed
Balasoupramanien, K, Comat, G, Renard, A, et al. Ultrasonography performed by military nurses in combat operations: a perspective for the future? J Spec Oper Med. 2022;22(3):65-69.CrossRefGoogle ScholarPubMed
Abrokwa, SK, Ruby, LC, Heuvelings, CC, Bélard, S. Task shifting for point of care ultrasound in primary healthcare in low- and middle-income countries—a systematic review [Internet]. eClinicalMedicine. 2022;45:101333. Accessed May 12, 2022. doi: 10.1016/j.eclinm.2022.101333 CrossRefGoogle Scholar
Weile, J, Frederiksen, CA, Laursen, CB, et al. Point-of-care ultrasound induced changes in management of unselected patients in the emergency department—a prospective single-blinded observational trial [Internet]. Scand J Trauma Resusc Emerg Med. 2020;28. Accessed May 12, 2022. doi: 10.1186/s13049-020-00740-x CrossRefGoogle Scholar
Burleson, SL, Pigott, DC, Gullett, JP, et al. Point-of-care ultrasound in resource-limited settings: the PURLS fellowship. Ultrasound J. 2020;12(1):14. Accessed May 12, 2022.CrossRefGoogle ScholarPubMed
Suttels, V, Du Toit, JD, Fiogbé, AA, et al. Point-of-care ultrasound for tuberculosis management in Sub-Saharan Africa—a balanced SWOT analysis. Int J Infect Dis. 2022;123:46-51. Accessed November 18, 2022.CrossRefGoogle ScholarPubMed
Kizito, PM, Bagonza, KD, Odakha, JA, et al. Diagnostic performance of point of care ultrasound compared to chest X-ray in patients with hypoxia at a teaching hospital emergency department in Uganda. Afr J Emerg Med. 2023;13(2):61-67. Accessed April 11, 2023.CrossRefGoogle Scholar
Handheld Portable Ultrasound Machine [Internet]. Butterfly Store. https://store.butterflynetwork.com/ca/en/. Accessed August 31, 2022.Google Scholar
Flick, D. Bedside Ultrasound Education in Primary Care. J Ultrasound Med. 2016;35(7):1369-1371. doi: 10.7863/ultra.15.08073 CrossRefGoogle ScholarPubMed
Robertson, TE, Levine, AR, Verceles, AC, et al. Remote tele-mentored ultrasound for non-physician learners using FaceTime: a feasibility study in a low-income country [Internet]. J Crit Care. 2017;40:145-148. Accessed May 12, 2022. doi: 10.1016/j.jcrc.2017.03.028 CrossRefGoogle Scholar
Shaddock, L, Smith, T. Potential for use of portable ultrasound devices in rural and remote settings in Australia and other developed countries: a systematic review. J Multidiscip Healthc. 2022;15:605-625.CrossRefGoogle ScholarPubMed
Henwood, PC, Mackenzie, DC, Rempell, JS, et al. A practical guide to self-sustaining point-of-care ultrasound education programs in resource-limited settings. Ann Emerg Med. 2014;64(3):277-285.e2.CrossRefGoogle ScholarPubMed
Doran, J, Hanna, R, Nyagura-Mangori, T, et al. Stakeholder perspectives on current determinants of ultrasound-guided thoracentesis in resource limited settings: a qualitative study. BMJ Open. 2022;12(12):e064638.CrossRefGoogle ScholarPubMed
Mollura, DJ, Soroosh, G, Culp, MP; RAD-AID Conference Writing Group. 2016 RAD-AID Conference on International Radiology for Developing Countries: gaps, growth, and United Nations Sustainable Development Goals. J Am Coll Radiol. 2017;14(6):841-847.CrossRefGoogle Scholar
Lamprecht, H, Lemke, G, van Hoving, D, et al. Poor return on investment: investigating the barriers that cause low credentialing yields in a resource-limited clinical ultrasound training programme [Internet]. Int J Emerg Med. 2018;11(1). doi: 10.1186/s12245-018-0168-9 CrossRefGoogle Scholar
Shah, S, Bellows, BA, Adedipe, AA, et al. Perceived barriers in the use of ultrasound in developing countries [Internet]. Crit Ultrasound J. 2015;7(1). doi: 10.1186/s13089-015-0028-2 CrossRefGoogle ScholarPubMed
Articles [Internet]. Israeli Flying Aid. Published 2014. Accessed September 22, 2022. https://ifaid.com/ifa-in-the-media/articles-israeli-flying-aid/ Google Scholar
DARA 2022 AGM Registration [Internet]. Google Docs. Accessed September 22, 2022. https://docs.google.com/forms/d/e/1FAIpQLSelyu0DFkKnXdAoTFxP7cOjbrmwJrV54moqN-eSz9GyapdGZA/viewform Google Scholar
Maw, AM, Galvin, B, Henri, R, et al. Stakeholder perceptions of point-of-care ultrasound implementation in resource-limited settings [Internet]. Diagnostics (Basel). 2019;9(4). doi: 10.3390/diagnostics9040153 Google Scholar
Bauer, I. More harm than good? The questionable ethics of medical volunteering and international student placements [Internet]. Trop Dis Travel Med Vacc. 2017;3. doi: 10.1186/s40794-017-0048-y CrossRefGoogle Scholar
Gibson, LE, Low, SA, Bittner, EA, Chang, MG. Ultrasound Teleguidance to Reduce Healthcare Worker Exposure to Coronavirus Disease 2019. Crit Care Explor. 2020;2(6):e0146. doi: 10.1097/CCE.0000000000000146 CrossRefGoogle ScholarPubMed
Providing healthcare to rural populations with Real Time Remote Telementored Ultrasound [Internet]. University of North Texas Health Science Center, 2022. Accessed Novevmber 18, 2022. https://hdl.handle.net/20.500.12503/30862 Google Scholar
Recker, F, Höhne, E, Damjanovic, D, Schäfer, VS. Ultrasound in telemedicine: a brief overview. Appl Sci (Basel). 2022;12(3):958.CrossRefGoogle Scholar
Britton, N, Miller, MA, Safadi, S, et al. Tele-ultrasound in resource-limited settings: a systematic review [Internet]. Front Public Health. 2019;7. doi: 10.3389/fpubh.2019.00244 CrossRefGoogle ScholarPubMed