Implementation of a procedural POCUS training programme for paediatric Surgeons in a resource-limited setting: a...

In public hospitals in low and middle-income countries, imaging services are typically unavailable outside daytime hours, delaying ultrasound access in paediatric emergencies. Implementation models for procedural point-of-care ultrasound (POCUS) in resource limited paediatric surgical units remain scarce. We describe the implementation of a pragmatic POCUS training programme in a Bolivian paediatric surgical unit.

Retrospective report of a case series (March 2020 - March 2024) following PROCESS 2020 guidelines.

operational feasibility, defined as the ability of the paediatric surgical team to perform ultrasound-guided hydrostatic reduction without concurrent sonographer presence.

reduction success rate. Three paediatric surgeons and one surgical resident participated in approximately 24 supervised sessions over a two-month period.

Twenty-five patients underwent ultrasound-guided hydrostatic reduction; from the third case onward, hydrostatic reduction procedures were performed without concurrent sonographer presence, including during periods without scheduled imaging coverage; 20 (80.0%) [95% CI 59.3-93.2%] achieved successful reduction; five required surgical conversion. Five patients with ileo-ileal intussusception and intestinal compromise underwent surgery. No perforation or other serious adverse event was documented in the available clinical records.

A pragmatic supervised training programme enabled a Bolivian paediatric surgical team with no prior formal ultrasound training to perform ultrasound-guided hydrostatic reduction without concurrent sonographer presence, providing preliminary feasibility evidence for procedural POCUS in resource-constrained paediatric surgical care.