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Point-of-Care Lung Ultrasound in Adults: Image Acquisition
Published on: March 3, 2023
Training for Pediatric Cardiac and Pulmonary Point of Care Ultrasound in Eastern Uganda
Jessica Schmidt1, Arthur Chiu1, William Okiror2
1Department of Emergency Medicine, University of Wisconsin, Madison, Wisconsin, USA.
Insights
A training program in cardiac and lung point-of-care ultrasound (POCUS) equipped healthcare providers in Uganda to accurately interpret pediatric images. This initiative enhances diagnostic capabilities in resource-limited settings.
Area of Science:
- Medical Education
- Diagnostic Imaging
- Global Health
Background:
- Caring for acutely ill children in resource-limited settings presents diagnostic challenges due to limited access to imaging.
- Point-of-care ultrasound (POCUS) offers a potential solution for rapid diagnostics in such environments.
Purpose of the Study:
- To develop and evaluate a training program in cardiac and lung POCUS for pediatric patients in eastern Uganda.
- To assess the quality of images and accuracy of interpretations by trainees after the program.
Main Methods:
- A training program involving lectures, hands-on practice, and individualized sessions was delivered to 14 healthcare professionals.
- Trainee performance was assessed via written exams, direct observation, and blinded review of 237 ultrasound studies.
- Image quality and interpretation accuracy were compared against expert reviews.
Main Results:
- Trainees achieved high image quality (94.2% lung, 93% cardiac) and accurate interpretations.
- Sensitivity and specificity for lung POCUS were 0.93 and 0.94, respectively; for cardiac POCUS, they were 0.86 and 0.94.
- All trainees passed written assessments, and 100% intended to integrate POCUS into their practice.
Conclusions:
- A POCUS training program can empower healthcare providers in resource-limited settings to perform high-quality pediatric cardiac and lung ultrasound.
- The program demonstrated accurate interpretation skills among trainees, suggesting POCUS can improve pediatric care.
- This study lays the groundwork for future research on POCUS's impact on pediatric patient outcomes in underserved regions.
Abstract:
Caring for children with acute illness is a challenge in limited-resource settings, especially when diagnostic imaging is limited or unavailable. We developed a training program in cardiac and lung point-of-care ultrasound (POCUS) for pediatric patients in eastern Uganda. Fourteen trainees including physicians, resident physicians and midlevels received training in cardiac and lung POCUS. Training included formal lectures, hands-on skills practice and individualized teaching sessions. Assessment included written knowledge assessment, direct observation and longitudinal image review. Blinded review of 237 consecutive ultrasound studies revealed satisfactory image quality (94.2% for lung and 93% for cardiac) and accurate image interpretation. Sensitivity and specificity of image interpretation were 0.93 (0.75-0.99) and 0.94 (0.78-0.99) for lung and 0.86 (0.71-0.95) and 0.94 (0.84-0.99) for cardiac compared with expert review. All trainees passed written knowledge assessments. After training, 100% of trainees reported that they would use POCUS in clinical activity and thought it would improve patient outcomes. Our training program indicated that trainees were able to perform high-quality cardiac and lung POCUS for pediatric patients with accurate interpretation. This builds a foundation for future studies addressing how POCUS can change outcomes for children in limited-resource settings.
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