James M. Daniels
SIU School of Medicine, USA
Title: The Use of Point of Care Ultrasound in an Acute Setting to Diagnose Orthopedic Trauma
Biography:
Dr. Daniels has an extensive background in the use of point of care ultrasound. He has edited three medical texts on this subject and has developed curriculum in this area for attending physicians, fellows, resident physicians, medical students, physician assistant students, and athletic training students. He was key in the development of a national curriculum for primary care physicians with the National Center for Procedures Institute.
Abstract:
Statement of the Problem: In many acute care settings (athletic contests, sports venues, military missions, and rural hospitals) 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 main way to evaluate patients in this acute setting. Recently, ultrasound machines have been reduced in size, encased in protective shells and have experienced cost reductions to make it possible to use imagery 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 by 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. 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.