Family and Community Medicine SIU School of Medicine, USA
Title: The Use of Point of Care Ultrasound in Acute Settings for Diagnosis of Orthopedic Truama
Dr. Hoffman is the fellowship trained in medical education and serves as Director of Research and Scholarly Activity for SIU’s departments of Family Medicine and Sports Medicine . She has edited a medical textbook in musculoskeletal care and develops curriculum and research in primary care and sports medicine ultrasound education for residents, fellows, and faculty.Dr. Hoffman is the fellowship trained in medical education and serves as Director of Research and Scholarly Activity for SIU’s departments of Family Medicine and Sports Medicine . She has edited a medical textbook in musculoskeletal care and develops curriculum and research in primary care and sports medicine ultrasound education for residents, fellows, and faculty.
Statement of the Problem: In many acute care settings (athletic contests, sports venues, military missions, rural hospitals, outpatient clinics), clinicians are faced with the problem of treating the patient on-site or transferring them to another treatment facility. History and physical exam are the primary ways to evaluate patients in this acute setting, but recently ultrasound machines have been reduced in size, encased in protective shells and have experienced cost reductions to make it possible to use imaging to further refine clinical decisions.
Methodology and Outcomes: Approximately 3 years ago our Department developed a point of care ultrasound (POCUS) curriculum for our primary care resident physicians and sports medicine fellows. Using a Canadian Model (EDE) designed to train physicians working in an emergency room and information from the United States Department of Defense, we trained faculty, residents and fellows on “7 scans every physician needs to know.” This process was completed through self-study modules followed by hands-on screening and refresher courses.
Findings: Pre and Post-test score results revealed this training was effective in teaching clinicians with little or no background in imagery to effectively use this technology in an acute setting.
Conclusion and Significance: We currently have a number of studies started in acute care settings to further define the use of POCUS in this setting by clinicians who received basic training using this modality. Additionally, one of our fellows was recently selected to serve as medical staff to a World Taekwondo Championship Tournament. The tournament was staffed by a number of Orthopedic surgeons, Primary Care Sports Medicine clinicians, Ophthalmologists and Orthopedic Trauma specialists. The POCUS exam was effective in playing a major role in the diagnosis of a retinal detachment, hemoperitoneum, deep vein thrombosis and confirmation of three fractures. These patients were all transferred to a local hospital where the above diagnoses were confirmed.