Cardiopulmonary ultrasound for critically ill adults improves diagnostic accuracy in a resource‐limited setting: the <scp>AFRICA</scp> trial

Becker, Torben K.; Tafoya, Chelsea; Osei‐Ampofo, Maxwell; Tafoya, Matthew J.; Kessler, Ross; Theyyunni, Nik; Yakubu, H.; Opuni, Daniel; Clauw, Daniel J.; Cranford, James A.; Oppong, Chris; Oteng, Rockefeller

doi:10.1111/tmi.12992

Cited by 26 publications

(28 citation statements)

References 36 publications

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“…POCUS is becoming standard of care for diagnostic and therapeutic interventions in a variety of clinical settings in highly developed medical systems (Bellamkonda et al 2015;Dietrich et al 2017;McLario and Sivitz 2015;Moore and Copel 2011). In recent years there has been an increasing effort to integrate POCUS into clinical care provided in resource-limited settings (Becker et al 2017;B elard et al 2018;Epstein et al 2018;Henwood et al 2017;Stanley et al 2017;Vinayak 2017;Vinayak and Brownie 2018;Zaver et al 2018). These efforts include initiatives to improve the relevance of ultrasound training programs enabling clinicians with a point-of care imaging modality.…”

Section: Introductionmentioning

confidence: 99%

Assessment of Point-of-Care Ultrasound Training for Clinical Educators in Malawi, Tanzania and Uganda

Shokoohi

Raymond

Fleming

et al. 2019

Ultrasound in Medicine & Biology

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Integrating point-of-care ultrasound (POCUS) to enhance diagnostic availability in resource-limited regions in Africa has become a main initiative for global health services in recent years. In this article, we present lessons learned from introducing POCUS as part of the Global Health Service Partnership (GHSP), a collaboration started in 2012 between the U.S. President's Emergency Plan for AIDS Relief (PEPFAR), the Peace Corps and Seed Global Health to provide health care work force education and training in resource-limited countries. A cross-sectional survey of GHSP clinical educators trained to use POCUS and provided with hand-held ultrasound during their 1-y deployment during the period 2013À2017. The survey consisted of 35 questions on the adequacy of the training program and how useful POCUS was to their overall clinical and educational mission. Clinical educators engaged in a series of ultrasound educational initiatives including pre-departure training, bedside training in the host institutions, online educational modules, educational feedback on transmitted images and training of local counterparts. In this study 63 GHSP clinical educators who participated in the POCUS trainings were identified, and 49 were included at the study (78% response rate). They were assigned to academic institutions in Tanzania (n = 24), Malawi (n = 21) and Uganda (n = 18). More than 75% reported use of POCUS in clinical diagnoses and 50% in determining treatment, and 18% reported procedural application of ultrasound in their practice. The top indications for POCUS were cardiac exams, second-and third-trimester obstetric exams, lung and pleura, liver and spleen and gynecology/first-trimester obstetrics. The largest perceived barriers were lack of ultrasound knowledge by the clinical educators, lack of time, equipment security, difficulty accessing the Internet and equipment problems. We concluded that our multiphase POCUS training program has increased the utility, acceptability and usage of POCUS in resource-limited settings. (

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Section: Introductionmentioning

confidence: 99%

Assessment of Point-of-Care Ultrasound Training for Clinical Educators in Malawi, Tanzania and Uganda

Shokoohi

Raymond

Fleming

et al. 2019

Ultrasound in Medicine & Biology

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“…1 We previously conducted a training in cardiopulmonary ultrasound (CPUS) for emergency medicine residents of the Komfo Anokye Teaching Hospital (KATH) in Kumasi, Ghana, as part of a larger trial assessing the impact of a CPUS protocol (based on the Rapid Ultrasound in Shock and Bedside Lung Ultrasound in Emergency protocols) in critically ill ED patients. [2][3][4][5] There is a paucity of literature on the long-term skill and knowledge retention after initial ultrasound training in LMIC. We thus completed a follow-up assessment after more than 9 months from initial training to assess its long-term impact.…”

Section: Introductionmentioning

confidence: 99%

Skill and knowledge retention after training in cardiopulmonary ultrasound in Ghana: an impact assessment of bedside ultrasound training in a resource-limited setting

Osei‐Ampofo

Tafoya

et al. 2018

Emerg Med J

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“…Many POCUS applications thought to have the highest utility in the RLS are familiar to developed-world clinicians. POCUS use in peripartum care, trauma, heart failure [11], undifferentiated hypotension or dyspnea [12,13], and deep venous thrombosis [14] in RLS are all welldescribed. In settings lacking confirmatory diagnostics, POCUS may be even more valuable to a patient's clinical evaluation than in a developed setting.…”

Section: Introductionmentioning

confidence: 99%

Point-of-care ultrasound in resource-limited settings: the PURLS fellowship

et al. 2020

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Background: The role of point-of-care ultrasonography (POCUS) is rapidly expanding in both resource-rich and resource-limited settings (RLS). One limitation to this rapid expansion has been the lack of educators adequately trained to teach this user-dependent skill. This is particularly true in RLS, where disease presentations, infrastructure limitations, and approach to medical education present unique challenges to the direct application of resource-rich emergency department POCUS curricula. Objectives: We describe the point-of-care ultrasound in resource-limited settings (PURLS) fellowship, a novel curriculum designed to provide advanced training and expertise in clinical care and POCUS application and education in RLS. Conclusion: Our curriculum design is one approach to create context-specific POCUS education for use in RLS, thereby improving patient care.

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Cardiopulmonary ultrasound for critically ill adults improves diagnostic accuracy in a resource‐limited setting: the AFRICA trial

Abstract: In an urban ED in Ghana, a CPUS examination improved the accuracy of the treating physician's initial diagnostic impression. There were no differences in 24-h mortality and a number of patient care interventions.

Cited by 26 publications

References 36 publications

Assessment of Point-of-Care Ultrasound Training for Clinical Educators in Malawi, Tanzania and Uganda

Assessment of Point-of-Care Ultrasound Training for Clinical Educators in Malawi, Tanzania and Uganda

Skill and knowledge retention after training in cardiopulmonary ultrasound in Ghana: an impact assessment of bedside ultrasound training in a resource-limited setting

Point-of-care ultrasound in resource-limited settings: the PURLS fellowship

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