SonoBYTE: Global Relief Ultrasound
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The scale of need, wide burden of disease, and complex systems challenges can at times be overwhelming in the global health arena. Focusing on small wins and long-term investment is key to programmatic success and sustainability. Training clinicians in bedside ultrasound effectively uses the same human resources to help shrink the gap between the broad imaging needs of a population and limited consultative capacity of radiology. The result is enhanced patient care, provider empowerment, and improved job satisfaction. Growing point-of-care ultrasound trainees into trainers themselves allows for local solutions to ongoing education needs and helps develop and address the most relevant home-grown research questions, results of which may have broader international practice implications. Building broader networks for bilateral point-of-care ultrasound training and research opportunities will be of global benefit.
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SonoBYTE: Global Relief Ultrasound
- 4. SonoBYTE
- 6. Global ultrasound training: keep the small wins in focus Trish Henwood, MD @PURE_Updates www.pureultrasound.org
- 8. slide of africa critical care setting
- 9. pregnant bellies getting scanned
- 10. pregnant bellies getting scanned
- 11. `
- 17. Amplify the bright spots *
- 19. • 2013 Initial training • 2014 Train-of-trainers program • 2015 Pneumothorax research idea • 2016 Study implementation • 2017 Results changing practice & curriculum Jean Paul’s POCUS evolution
Editor's Notes
- Das SMACC Graphic in Background Audio: Music or Sonar or Ambulance
- Thanks for having me. Today I’d like to talk to you about how POCUS training has a transformative effect on patient care and practitioners in resource-limited settings
- I was asked to speak about global relief efforts with ultrasound, and while I have found having an US invaluable in the care of my patients in place like field hospital in post-earthquake Haiti & ETU in Liberia…Nowhere, have I seen skill with this device save more lives & change outcomes more for patients than in the hands of trained practitioners, providing day to day care, in the developing world. (With ultrasound transducer in my hand on stage)
- In hospital settings where their patients are more often critically ill by the time they come to care…where imaging resources and diagnostic testing are limited not just in one extreme environment, but on a constant basis. These practitioners are the force multipliers I want to discuss.
- Even in cases where healthy pregnant patients are coming for routine antenatal care. Without ultrasound training & use, practitioners may not become aware of major potential delivery complications.
- Things like placenta previa & Multiple gestations, maybe even triplets…
- It scares me to think that if were an expectant mother on Pemba Island in Zanzibar last year I wouldn’t have had access to any antenatal ultrasound…and this large asymptomatic cervical fibroid would not have been unidentified…and would likely result in obstructed labor, and a poor outcome for me and my baby. PAUSE. But now there is an ultrasound program on Pemba…
- Now in Pemba we have an ultrasound training program including trainees like Fatma who were previously without ultrasound equipment or training in their prac Fatma 00:00-00:23 blended into 00:30 to 0:41 “hello…free fluid in eclampsia…” “and mothers with ruptured cyst…this ultrasound helps us save many lives of the mothers and unborn fetus.”
- This is Gabin, he is now a rising leader in emerge med in East Africa. He was one of my first trainees in Rwanda in 2013. He took his initial training in basic echo and is now doing many advanced applications and has become an invaluable resource in his hospital. Let’s hear how far he has is taken his initial basic training in identifying a pericardial effusion by ultrasound since then…
- Gabin clip 81 sec 17:48-18:16 blended into 18:22-19:00 blended into 19:08-19:23. “I do find cardiac makes a lot of difference…since nobody else would be doing that” “You can almost find anything around here…you will get all kinds of these things” “Even if you don’t find the dx…est in setting of emergency”
- This is his colleague Olivier, also working in the first EM residency w US as a formal part of their curriculum - finding it invaluable in evaluation of their ED patients…
- Olivier clip 0:11-1:21 “We are seeing many patients where US helping…US made dx”
- Among challenges with resources for trainings and equipment issues, trying to focus on growing POCUS trainees into trainers like Gabin and Olivier allows for a local and sustainable solution to ongoing need. They can develop & address the most relevant home-grown research questions, results of which may have broader international practice implications. This is the proximal goal, the trainees taking over…
- This is the proximal goal, our trainees teaching… JP Kam clip 24:57-25:12 blended into 24:35-24:56 “These are our spaces….will help us visualize pericardial space” “Up to the diaphragm there is …excellent”
- Process of developing trainers is long but certainly worthwhile. Eventually trainees begin to ask and answer important ultrasound related research questions. For example, Jean Paul Shumbushu, a surgeon in Rwanda we previously trained initiated a study evaluating the accuracy of bedside US by surgery residents after a 4hr training relative to serial CXR for patients with chest tube placement for PTX.
- Vicki Noble calls ultrasound ‘the universal gift’ let’s here how valuable it has become to former trainees An integrated approach to ongoing ultrasound education and research will result is the greatest reduction in burden of disease by ultrasound… Olivier clip 1:48-2:55 I can tell you from my perspective I don’t know what our dept becomes without ultrasound…US has become paramount for us”
- This is Olivier last week, teaching my fellows in Boston about how he uses ultrasound in his practice, and learning about our system. I think this should be the goal.
- Building broader networks for mentorship and bilateral POCUS training and research opportunities with amazing practitioners, like the ones I have introduced you to, will be of global benefit…and I would encourage you all to consider getting involved in efforts like this.