Dedicated to the development of Emergency Medicine.
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If this is all new to you, start here!
If you already have some insight into PoCUS, make sure you have a solid understanding of The Basics. This section has just been updated and is looking more beautiful than ever. Check it out!
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Here you will find an original work of literature review, strategically compiled with dynamic US images. The modular approach is designed as a PoCUS self-teaching tool. Each module reviews a core subject using a practical approach to image acquisition and interpretation; in most cases addressing simple questions with simple answers. Explore the content overview!
Our proposal is to focus on reviewing one module at a time, becoming familiar with the anatomy, technique and US clips, and then exploit as much self-directed practice as possible in the real world. Then, move to the next module. Building yourself a proper Portfolio will be critical in tracking progress and achieving accreditation.
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Finally, we’ve created a Cases Blog section! We will be updating this as often as possible with hand-picked cases. We are looking to expand our presence to social media, if this is something you would like to collaborate with please get in touch.
What’s New?
Why POCUS?
INTRODUCTION
Point of care ultrasound is a safe and quick imaging technique. Unlike other diagnostic modalities, ultrasound has almost no contraindications, it does not involve radiation exposure, and neither require the use of contrast nor a specific patient’s preparation. As a result, its use has widely spread in recent years, becoming not only more accessible but fundamental in acute care. For the emergency physician, perhaps the most important feature is that the scan can be quickly performed at the bedside of the patient, even when this one is unstable and other interventions are being applied simultaneously. To me personally, the PoCUS has implied a redefinition of clinical practice, particularly in austere isolated environments and the confinements of airborne retrieval, where no other assessment tool has been of greater value.
Still, it is essential to understand that point-of-care ultrasound is a limited and focused assessment in the emergency setting. PoCUS has different goals than the formal ultrasound performed by a Radiologist, and its adequate and successful use lies in answering specific questions related to defined clinical scenarios. Under this focused scope and with training oriented to address simple specific questions; the technique displays a relatively quick learning curve, subsiding its operator-dependant nature.
Bedside ultrasound has numerous and varied applications, which prove enormously useful in the emergency department. These applications range from aiding in the diagnostic process, guiding invasive procedures, and providing information that prompts radical, life-saving decisions. Hence, developing skills in POCUS is a must for the emergency clinician.
Objetives.
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Ultrasound Education.
ultra-sono.com is a repository of essential and up to date emergency ultrasound content, relevant to the education, development and clinical practice of the speciality.
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Multilingual.
Since its inception, this site has offered something different by displaying digital content on a fully bilingual platform. Our commitment has been to ensure the same access to quality education in Spanish and English languages; thus, broadening the FOAMEd and PoCUS concepts.
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Attractive.
By incorporating a concern for aesthetics & style as elements that make education attractive; the intention is to deliver content in a way that is engaging, minimalistic and easy to navigate.
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Free.
This website adheres to the FOAMed concept and the belief that good quality education should be free and readily accessible. We will sustain this effort out of contributions.
Impact.
During the last two years, while practising Emergency & Retrieval Medicine in the Chilean Patagonia, this digital project became the backbone for the first EM PoCUS course in the Aysen Region. Locally, it transformed our daily practice and positioned bedside ultrasound as a standard of care.
The development of this website filled a gap in terms of access to knowledge and learning resources for the Spanish-speaking medical community. Today, https://elpocus.cl/ has become a reference, receiving regular visits from countries all over Latin America. The success stemming from this project placed me as a speaker at the 2021 International World Extreme Medicine Conference in Edinburgh. "A year in Patagonia: Point of Care Ultrasound in Limited Resource Settings" was received with interest and enthusiasm, and it provided valuable intercultural insight.
Currently, this project is based in London and has grown into a team of collaborators with a notorious EM background. Together, we have replicated the success of the original PoCUS course and implemented it within the teaching schedule of the Royal London Hospital ED, a world-leading Mayor Trauma Center.
Learn.
The future is now, let’s make a change.
History.
This project started in 2020 as an answer to some of the issues inherent to rural Emergency Medicine. Although experimental in origin, the project was core in successfully implementing the first PoCUS course for the Puerto Aysen Hospital Emergency Department. Its team performs in a rural mid-complexity hospital’s Emergency Department located at the heart of Chilean Patagonia. Thus, clinical practice takes place in a region of unforgiving weather that is as geographically stunning as isolated and challenging. Moreover, the patient flow is undifferentiated, ranging from acute O&G and pediatric consult; to multi-level trauma and advanced airway management.
The geographical conditions of Patagonia translate into a unique challenge to emergency medicine. The population scatters around mountains, fjords and islands, while the only option to get a CT scan, operating theatre, or ICU lies within the regional referral centre in Coyhaique. Consequently, the capacity to reach a definitive diagnosis and treatment requires several hours of ambulance rally, making air retrieval the only viable option for life-threatening conditions. Furthermore, the decision of patient transfer is in itself difficult, as it must be justified and weighed against the extreme weather or transport availability.
In such a context, the introduction of point-of-care ultrasound as an extension of physical examination represented a paradigm shift. POCUS plays a determinant role in formulating a hypothesis in an otherwise obscure patient, and it can change therapeutical conduct earlier, potentially improving the outcome. In a limited-resource setting, POCUS is invaluable. This focused technique requires a defined amount of training and can even be self-taught, allowing its implementation by any healthcare provider.
Still, this project has always been about having fun and creating something that makes me feel good, and hopefully, will be useful to others. The effort of ultra-sono.com is directed towards medical practitioners of any level and background who could find in this content an easier approach to mastering this skill. Thanks in advance to thepocusatlas.com for their excellent GIF images and to its creators Michael Macias & Matthew Riscinti, for their support and guidance at the beginning of this enterprise.
