Review of Feasibility and Impact of Point-of-Care Ultrasound Use in Rural Guatemala Outreach Clinics

Despite advances in medical technology, diagnostic gaps persist in low-resource settings. Point-of-care ultrasound (POCUS) is a portable, accessible tool that can expedite diagnosis, guide treatment, and improve clinical outcomes. However, few studies quantify its real-world impact, specifically in low-resource settings. This study seeks to evaluate how POCUS influences clinical diagnosis and treatment decisions in areas with limited radiologic support, as well as highlight cases where its use influenced patient management.

POCUS use during five days of a primary care outreach clinic in five rural Guatemalan communities was documented. A POCUS-certified physician conducted abdominal, pelvic, renal, and thyroid scans with participating medical students. Verbal consent was obtained via certified translators and all images were deidentified. Data on pre-imaging suspicion and post-imaging diagnosis were documented, and diagnoses were categorized as confirmed, ruled out, or changed.

Of 219 patients seen, a total of 27 ultrasounds were performed. The most frequent type of scan was pelvic (n=12, 44.4%), followed by abdominal (n=11, 40.7%). Fourteen scans (51.9%) confirmed the suspected diagnosis, 10 (37.0%) ruled out structural abnormalities (i.e. leiomyomas, bladder abnormalities), and 3 (11.1%) changed diagnosis.

POCUS use demonstrated practical utility that can allow physicians to offer definitive diagnoses and treatment options in communities with limited radiology support. This readily accessible imaging modality demonstrated usefulness in the diagnosis of conditions like hyperthyroidism, cholelithiasis, and numerous gynecologic conditions. Its utilization in primary care outreach clinics offers a method to enhance diagnostic accuracy and should be further explored.