Point-of-care ultrasound: The new district focus

Abstract

Background: Point-of-care ultrasound (POCUS) improves patient outcomes. The current POCUS curriculum of the Emergency Medicine Society of South Africa is based on guidelines from the United Kingdom with a different burden of disease (BoD) and available resources than encountered locally. Aim: To determine which modules of the POCUS curriculum should be implemented to better equip doctors working at a district hospital in the West Coast District (WCD), South Africa. Setting: Six district hospitals within the WCD. Methods: A descriptive cross-sectional survey with questionnaires for medical managers (MMs) and medical practitioners (MPs). Results: A response rate of 78.9% for MPs and 100% for MMs was obtained. MPs rated the following modules of POCUS most relevant to their daily practice: (1) first trimester pregnancy; (2) deep vein thrombosis; (3) extended focused assessment with sonography in trauma; (4) central vascular access; and (5) focused assessment with sonography for human immunodeficiency virus (HIV) and tuberculosis (TB) (FASH). Conclusion: There is a need for a POCUS curriculum informed by the local pattern of disease. Priority modules were identified based on the local BoD and reported relevance to practice. Despite the availability of ultrasound machines within the WCD, few MPs were accredited and able to perform POCUS independently. There is a need to implement training programmes for medical interns, MPs, family medicine registrars and family physicians working in district hospitals. A relevant curriculum for POCUS training based on the local needs within communities has to be developed. Contribution: This study emphasises the need for a locally informed POCUS curriculum and training programmes.

Keywords

• point-of-care ultrasound
• district hospitals
• under-resourced settings
• curriculum
• west coast district.