Point-of-care ultrasound training in Indian emergency medicine programs: A resident's perspective

• Published in: International journal of academic medicine Vol. 3; no. 2; pp. 263 - 267
• Main Authors: Thomas, Vimal, Abraham, Siju, Balakrishnan, Jayaraj, Krishnan, S, Amalakat, Ajay, Palatty, Babu
• Format: Journal Article
• Language: English
• Published: Wolters Kluwer India Pvt. Ltd 01.07.2017
• Subjects: residents; Emergency medicine; Point of care ultrasound
• ISSN: 2455-5568; 2455-5568
• DOI: 10.4103/IJAM.IJAM_77_16

Background: Emergency medicine (EM) as a specialty in India is at its infancy. Point-of-care ultrasound (POCUS) is an indispensable tool for the emergency physician (EP). We sought to determine the current experience and resources of POCUS training among EM teaching programs in India. Methods: At a national EM board review course, a survey was carried out among 41 residents from 15 different teaching institutes across seven states of India. The survey consisted of questions pertaining to their experience and knowledge in performing basic and advanced POCUS examinations and its utilization in their department. Results: Most residents (90.2%) were of the opinion that POCUS is an indispensable tool for the EP. All residents had access to an ultrasound (US) machine, with 90.2% having at least one dedicated machine in their department. 12.1% of the residents utilized POCUS less than five times a day while 14.6% reported using US more than twenty times a day. 68.5% of residents identified the major modality of learning POCUS was from a mentor, and about one-third were exclusively dependent on it. The least utilized sources were books and lectures (19%). Extended focused assessment with sonography in trauma (EFAST) was the most frequently performed examination (95%) and was performed with highest level of confidence. Among the advanced examinations, residents knew how to perform and interpret airway (53.7%) and renal sonography (53.7%) the most while they were least familiar with ocular sonography (19%). 70.1% residents reported that POCUS was utilized for facilitating vascular access, 53.7% for nerve blocks, and paracentesis around 19%. Only 46% reported that other departments rely on their findings to make clinical decisions. Conclusion: POCUS was utilized by the residents for different diagnostic examinations and interventions, with the most common being EFAST. The most common learning source of POCUS was from hands-on training by a mentor. There exists a need for guidelines or standardization of POCUS in the EM curriculum to achieve resident competency. The following core competencies are addressed in this article: Interpersonal skills and communication, Medical knowledge, Patient care, Systems-based practice.