Medical

With the revamping of the H.E.R.O medical mission objectives in Guyana, we newly initiated Point of Care Ultrasound (POCUS) teaching at the sites we visit. POCUS is the practice of the use of ultrasound by a trained medical professional to assess patients. POCUS is cost-effective, portable, and can reduce the time to diagnosis and treatment of many medical problems, this is especially useful in resource-limited settings. Most recently we had the opportunity to teach POCUS at One Mile Clinic in Linden and at Linden hospital. At One Mile we worked one on one with the head nurse and the clinic physician teaching them how to perform OB ultrasound during their OB clinic day. By the end of the day the providers were able to accurately determine fetal heart beat and use various techniques to measure gestational age for example using the head circumference and, femur length. Additionally, they were educated on identification of the ovaries and recognition of ultrasound signs suggestive for ectopic pregnancy. The providers were excited to learn and found the hands on learning experience very helpful to their practice.

Similarly we provided ultrasound education to the resident physicians and nurses of Linden Hospital. Attendees of the 4- hour course were educated on Extended Focused Assessment in Trauma ( E-FAST), Right Upper quadrant (RUQ)/Biliary and Point of Care ECHO. After the didactic session, the course participants each had the opportunity to practice what they learned on each other. With guided practice, they were able to identify and understand the clinical significance of recognizing specific anatomical structures. While at Linden Hospital we were also able to visit the ICU, and perform ECHO on two critically ill patients. We were to able to teach and assist the physicians in determining cardiac output using several ultrasound techniques.

At Georgetown Hospital we provided education to the surgical residents. After a 2 hour didactic session, junior physicians engaged in hands on practice of RUQ ultrasound and E-FAST. The senior physicians were able to gain understanding in ultrasound physics, while learning advanced techniques in using their own ultrasound unit to capture better images.

Overall the ultrasound teaching, lectures and hands on experience was well received and we were encouraged to return multiple times per year for continued education and practice. In the future one of H.E.R.O’s goal is to identify clinics that we can continuously work with over the next 2-3 years and teach POCUS. Thereby allowing use to make a linear assessment of the productivity and feasibility of continuing such a program.

Authored by,
Dr. Orinthia King
H.E.R.O Board Member
Clinical Ultrasound Director
Department of Emergency Medicine
Wyckoff Heights Medical Center
Brooklyn, New York