September 2022: GUSI – POCUS Training is For Everyone
For this newsletter, we thought we would share some of GUSI’s origin tale! Read onward to learn more about the true motivations for why Mena started GUSI.
Mena’s Origin Tale
My grandfather Francisco Ramos died before I was born in a small town in Southern Leyte, Philippines. In his 30’s, he developed abdominal pain and the family couldn’t afford to take him to the neighboring town where they had diagnostic imaging. He became weaker and eventually passed.
Fast forward 50 years later, I became a doctor and during my POCUS elective in Family Medicine Residency at Contra Costa, I had an “aha” moment. In the hands of a trained medical provider, POCUS is a tool that can give immediate diagnostic answers anywhere in the world – and could have maybe changed the outcome for my entire family – if my grandfather had been able to access this technology. I think any clinician who does a physical exam can provide even better care with POCUS. Now that the technology is more widely available, there is no reason why patients shouldn’t benefit from it.
My colleague and mentor Dr. Kevin Bergman and I started Global Ultrasound Institute (GUSI) in 2018, to transform patient care by training providers around the world in point of care ultrasound. To save lives, to help people, and to help change the course for families and communities around the world.
Check out these photos from GUSI’s first in person course in West Virginia in 2018!
And here is a photo of Kevin and Mena getting the GUSI domain name in 2018!
GUSI has now been around for 4+ years and counting! And this most recent publication from The Journal of the American Board of Family Medicine summarizes the best why we exist, and why we will continue to persist in our goal of expanding POCUS throughout the healthcare system – for the betterment of our patients, our clinicians, and our global healthcare community.
This goal is also realized in publications such as this featuring Dr. Haldeman and his work with training the next generation of family medicine clinicians in Zambia with POCUS.
Ultimately, with POCUS, we hope that our humble origins will lead to a dismantling of barriers in access to care, and make a contribution to a more fair and equitable global healthcare system.
Out of all of our accomplishments and achievements, we are most proud of our flagship course, POCUS Training for Primary Care. In 2018, this course started with the goal of training primary care clinicians in basic POCUS skills around the US, and quickly we took this course globally in 2019. With this expansion, we now teach advanced applications in addition to basic POCUS skills globally.
We are proud to hold our next course this October in San Francisco! This highly acclaimed two-day, in-person course combines high-yield lectures and hands-on scanning sessions, and also offers CME. Most of all, the emphasis is on maximizing POCUS hands on scan time through a low learner:ultrasound ratio of 3:1.
Check out some highlights from our last course in April 2022:
For this month’s newsletter, we are highlighting our origin tale. We also want to highlight our faculty by sharing some of their most impactful POCUS publications and tie it into our case studies.
Case Study #1
You are working in a remote access clinic and your last patient of the day is a 65-year-old man who was recently incarcerated for 2 years and released 2 weeks ago. He is unclear about his medical history and does not recall the names of any of his medications. As part of your screening exam, you find out that he has had low-grade fevers, night sweats, and a persistent cough with occasional bloody sputum. As part of your medical work up, you will order outpatient labs and chest x-ray imaging studies. However, you are concerned that he is at high risk for pulmonary tuberculosis. You decide to perform a POCUS lung exam because your findings could help determine if he needs to be transferred to a tertiary care facility today, or can continue to get an outpatient workup.
Lung Ultrasound (LUS) has been found to be an excellent adjunct to a history and physical, especially when evaluating for lung pathology such as tuberculosis. This article, based out of Lima, Peru which features two GUSI faculty as authors – Dr. Matthew Fentress, as primary author, and founder Dr. Kevin Bergman, found that LUS has a role in screening and diagnosis of pulmonary tuberculosis in areas where access to xray and other imaging modalities are limited.
Learn more about LUS and the management of pulmonary tuberculosis here. Learn more about the technique of LUS here.
Case Study #2
A 35-year-old woman who suffers from frequent kidney stones comes to your clinic with left- sided flank pain. She is pregnant, and now in her second trimester. This is her first pregnancy and she has not had any complications, and follows up regularly with OBGYN. In the exam room, she tells you that this feels similar to her previous kidney stones. You decide to perform a POCUS exam of the kidneys as initial testing to avoid unnecessary radiation exposures. Based upon the image, you are able to diagnose moderate hydronephrosis.
To learn more about POCUS and application within nephrology to evaluate kidney by reading this editorial from Dr. Nahreen Ahmed, GUSI faculty published in “Point-of-Care Ultrasound for the Nephrologist” in Advances in Chronic Kidney Disease.
This article is an important publication highlighting that POCUS provides necessary clinical information and reduces patient harm through radiation when evaluating for renal stones, as compared to CT. Learn more here about how POCUS can also be used to help measure the size of renal stones.
Case Study #3
You are part of a medical mission that is working in a hospital that was recently impacted by an earthquake. Much of the infrastructure of that hospital and city have been damaged. Many of the patients are now seeking care, a few days after the earthquake with emergencies that range from routine medical chief complaints, or severe crush injuries, long bone fractures, and other acute and subacute pathology. You anticipate that you will need to do many procedures such as central line placement and fracture dislocation reductions where POCUS guidance will be important. As you prepare for your next patient, who has severe wrist pain, you note that you are about to run out of the commercial ultrasound gel and you wonder what you can do to obtain more gel or create your own.
This article with Dr. Abiola Fasina, GUSI faculty shows that non commercial ultrasound gel has an important role in POCUS, especially in resource limited areas. Read more here.
Read more here about POCUS and the management of fracture dislocation and reduction.
Dr. David Mwonga Mulli is a trained Radiosonographer/Echocardiographer, currently working for the University of Nairobi, Kenya, Faculty of Health Science, Department of Diagnostic Imaging and Radiation Medicine (DIRM). David is passionate about getting POCUS available in his home country of Kenya and is GUSI’s lead instructor for site training for nurse midwives in Kenya.
GUSI recently traveled to Skagit Regional Health Clinic in Mount Vernon, WA to teach family medicine and internal medicine residents the power of POCUS in clinical care.
GUSI Gives Back
Coming up this fall, we are translating all of our course content into Ukrainian in collaboration with clinicians in Ukraine. This content is designed to be made available to all clinicians in Ukraine for free in order to provide clinical care for their patients.
GUSI in the News
Our recent POCUS training course at the University of Arkansas for Medical Sciences (UAMS) Department of Family and Preventive Medicine in Little Rock was featured in local news. Read the article here.
Register for our FREE Webinar
Join us on October 12 (9am PST/12pm ET) to hear from our panel of experts – Dr. Paul Bornemann (FM, University of South Carolina), Dr. Viveta Lobo (ER, Stanford University), and Dr. Puja Dalal (FM, Novant Family Medicine Residency) – on how to build a business case for creating a POCUS program at your facility.
GUSI in the Community
GUSI partnered with the Northwell Center for Global Health to deliver an in person POCUS training experience for family medicine faculty at the Georgetown Public Hospital Corporation (GPHC) in Georgetown, Guyana. The family medicine residency at GPHC serves as Guyana’s only family medicine residency in the country and a core pipeline for primary and rural health care providers.
Kevin, Mena, & the GUSI Education Team
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