Diagnostic point-of-care ultrasound in medical inpatients at Queen Elizabeth Central Hospital, Malawi: an observational study of practice and evaluation of implementation.
Africa
Malawi
echocardiography
point of care ultrasound
Journal
Transactions of the Royal Society of Tropical Medicine and Hygiene
ISSN: 1878-3503
Titre abrégé: Trans R Soc Trop Med Hyg
Pays: England
ID NLM: 7506129
Informations de publication
Date de publication:
02 08 2021
02 08 2021
Historique:
received:
26
06
2020
revised:
23
09
2020
accepted:
02
11
2020
pubmed:
17
11
2020
medline:
6
8
2021
entrez:
16
11
2020
Statut:
ppublish
Résumé
In less well-resourced settings, where access to radiology services is limited, point-of-care ultrasound (POCUS) can be used to assess patients and guide clinical management. The aim of this study was to describe ultrasound practice in the assessment of medical inpatients at Queen Elizabeth Central Hospital, Blantyre, Malawi, and evaluate uptake and impact of POCUS following the introduction of a training programme at the college of Medicine, Blantyre, Malawi. : A weekly prospective record review of sequential adult medical inpatients who had received an ultrasound examination was conducted. Of 835 patients screened, 250 patients were included; 267 ultrasound examinations were performed, of which 133 (50%) were POCUS (defined as performed by a clinician at the bedside). The time from request to performance of examination was shorter for POCUS examinations than radiology department ultrasound (RDUS) (median 0 [IQR 0-2, range 0-11] vs 2 [IQR 1-4, range 0-15] d, p=0.002); 104/133 (78.2%) POCUS and 90/133 (67.7%) RDUS examinations were deemed to have an impact on management. Following the introduction of a training programme in POCUS, half of all ultrasound examinations were delivered as POCUS. POCUS was performed rapidly and impacted on patient management. POCUS may relieve the burden on radiology services in less well-resourced settings.
Sections du résumé
BACKGROUND
In less well-resourced settings, where access to radiology services is limited, point-of-care ultrasound (POCUS) can be used to assess patients and guide clinical management. The aim of this study was to describe ultrasound practice in the assessment of medical inpatients at Queen Elizabeth Central Hospital, Blantyre, Malawi, and evaluate uptake and impact of POCUS following the introduction of a training programme at the college of Medicine, Blantyre, Malawi.
METHODS
: A weekly prospective record review of sequential adult medical inpatients who had received an ultrasound examination was conducted.
RESULTS
Of 835 patients screened, 250 patients were included; 267 ultrasound examinations were performed, of which 133 (50%) were POCUS (defined as performed by a clinician at the bedside). The time from request to performance of examination was shorter for POCUS examinations than radiology department ultrasound (RDUS) (median 0 [IQR 0-2, range 0-11] vs 2 [IQR 1-4, range 0-15] d, p=0.002); 104/133 (78.2%) POCUS and 90/133 (67.7%) RDUS examinations were deemed to have an impact on management.
CONCLUSION
Following the introduction of a training programme in POCUS, half of all ultrasound examinations were delivered as POCUS. POCUS was performed rapidly and impacted on patient management. POCUS may relieve the burden on radiology services in less well-resourced settings.
Identifiants
pubmed: 33197258
pii: 5983704
doi: 10.1093/trstmh/traa137
pmc: PMC8326953
doi:
Types de publication
Journal Article
Observational Study
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
863-869Subventions
Organisme : German Federal Ministry of Economic Cooperation and Development
ID : 16.2035.0-002.00
Informations de copyright
© The Author(s) 2020. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene.
Références
BMC Health Serv Res. 2018 Aug 6;18(1):607
pubmed: 30081880
Trop Med Int Health. 2016 Mar;21(3):294-311
pubmed: 26683523
Int J Emerg Med. 2010 Feb 27;3(1):49-52
pubmed: 20414382
World J Emerg Med. 2016;7(3):178-82
pubmed: 27547276
Ultrasound J. 2019 Dec 27;11(1):34
pubmed: 31883027
N Engl J Med. 2011 Feb 24;364(8):749-57
pubmed: 21345104
Rev Recent Clin Trials. 2018;13(4):243-251
pubmed: 29651944
Am J Trop Med Hyg. 2017 Feb 8;96(2):488-492
pubmed: 27994100
Am J Trop Med Hyg. 2010 Mar;82(3):512-5
pubmed: 20207884
J Trauma. 2004 Aug;57(2):288-95
pubmed: 15345974
Chest. 2015 Jun;147(6):1659-1670
pubmed: 26033127
Crit Ultrasound J. 2012 Nov 21;4(1):21
pubmed: 23171481
J Emerg Med. 2017 May;52(5):723-730
pubmed: 28284769
Am J Emerg Med. 2017 Dec;35(12):1984.e3-1984.e7
pubmed: 28851498
PLoS One. 2018 Apr 25;13(4):e0194774
pubmed: 29694406
J Trauma. 1995 Jun;38(6):879-85
pubmed: 7602628
Trans R Soc Trop Med Hyg. 2013 Jul;107(7):405-10
pubmed: 23764740
Int J Infect Dis. 2017 Mar;56:229-236
pubmed: 27836795
Am J Trop Med Hyg. 2016 Jan;94(1):8-21
pubmed: 26416111
Trans R Soc Trop Med Hyg. 2020 Jan 6;114(1):38-48
pubmed: 31735956