Category Archives: Diagnostic

POCUS in Medical Education



About Our Guest

Kate Deiling has been the Ultrasound Instructor at Rowan University School of Osteopathic Medicine in Stratford, NJ, since the inception of point-of-care ultrasound (POCUS) in the pre-clerkship medical curriculum in 2019. As part of the school’s simulation center, she teaches first and second-year medical students all modules of POCUS that include online education, a manikin-based high-fidelity simulator, and live hands-on training sessions utilizing 10 ultrasound machines. Together, these sessions help to facilitate the learning and development of essential psychomotor and cognitive skills for ultrasound probe handling, image interpretation, diagnoses, and clinical decision-making. In addition, a 2-week comprehensive POCUS elective is offered to fourth-year students with POCUS sessions for residents and faculty being developed.

Kate graduated from Thomas Jefferson University and has been practicing ultrasound for over 30 years in various capacities. Most recently, she worked extensively as a staff sonographer and was designated as the ultrasound education coordinator for a large multi-office radiology center. Early in her career, Kate worked exclusively in pediatrics at the Children’s Hospital of Philadelphia and then moved on to a position as a clinical consultant for a major manufacturer. Following her work as an applications specialist, she went to work in perinatology at several antenatal testing units in both academic institutions and private settings. Her husband is also a graduate ultrasonographer from Thomas Jefferson University. For many years, Kate and her husband operated as independent contractors providing ultrasound services to radiology centers and several private offices. They have 3 adult children, including their oldest, who is a physician specializing in regional anesthesia at the University of Virginia and uses POCUS daily. Kate very much enjoys outdoor activities and traveling with family and friends, especially to US National Parks.


The Health Wagon: Mobile Rural Healthcare Since 1980



About Our Guest

As a Family Nurse Practitioner and the President and CEO of St. Mary’s Health Wagon, Dr. Teresa Tyson leads a medical nonprofit in Central Appalachia. St. Mary’s Health Wagon exists as the region’s only safety net health care clinic for far southwest Virginia. Tyson leads her clinic in promoting the mission of providing quality, affordable, accessible care to all with an emphasis on serving the medically underserved. St. Mary’s Health Wagon is a free nurse managed health clinic consisting of three stationary and two mobile clinics, serving Lee, Scott, Wise, Dickenson, Buchanan and Russell Counties. St. Mary’s Health Wagon is one of the oldest, if not the oldest, mobile clinic in the United States, serving patients since 1980. In an effort to expand access to primary and specialty health care services, Tyson is currently overseeing the construction of a stationary dental clinic in Wise County. Tyson’s leadership in the healthcare sector has garnered notable recognition including interviews from media that include: 60 Minutes, Nightline, CBS Nightly News, Inside Edition, Washington Post, New York Times along with other extensive media attention, including international press, regarding her efforts to provide access to health care to the poor and marginalized in the Appalachian region. Tyson has presented at the United Nations and the World Health Organization numerous times. Tyson is at the forefront of healthcare innovation. Tyson introduced the first monoclonal antibody infusions and post-COVID clinics to Central Appalachia. This past year, Dr. Tyson initiated a medication-assisted treatment program, addressing the opioid epidemic with an evidence-based integrated treatment model using injectable diversion free medications. Tyson is most proud of the Health Wagon’s renamed annual health outreach, Move Mountains Medical Mission (M7). Following nineteen years of collaboration, Tyson continues to host this event, which she co-founded with Stan Brock of Remote Area Medical (RAM) and Sr. Bernadette Kenny in 1999. Dr. Tyson is a preceptor to medical, nursing and business students from forty-three colleges and universities. In 2015, Tyson was an instrumental partner in the first ever FAA approved drone delivery of medications in the United States, in partnership with Flirtey, NASA Langley and others. The historic drone has been inducted into the Smithsonian’s National Air and Space Museum. Tyson is a strong business development professional and is skilled in nonprofit organization management, budgeting, fiscal management, fundraising, capital projects management, communications strategy, strategic planning, project management, grants management, event planning, social media, public speaking, marketing, and healthcare policy. Tyson serves on many healthcare boards, advisory councils, and coalitions. Tyson also serves as a guest speaker on topics such as healthcare access, healthcare disparities, vulnerable populations, mobile health, Department of Defense’s Innovative Readiness Training health expeditions, nurse managed clinics and a variety of other issues. Tyson is the co-founder of Forever Young Aesthetics and Weight Loss Management in Norton, Virginia. Tyson’s medical clinic brought platelet rich plasma therapy – a natural treatment for injured joints – to the area. Tyson is also co-founder of Hettie’s Haven – a specialized residential home designed to assist individuals with intellectual disabilities in Coeburn, Virginia. Tyson is married to Tim Tyson. They are blessed with a family of five wonderful children: two boys and three girls.


Increasing Global Access to POCUS



About Our Guest

Brandon Greer, NP, has been a Nurse Practitioner for 1.5 years, and an Emergency Nurse for about 10 years. He has worked in a number of facilities, ranging from outpatient clinics to level 1 trauma centers. Brandon also teaches as an adjunct nursing professor, as well as an instructor of ACLS, BLS, PALS, and POCUS. He has worked to augment the role of POCUS in his community, using it at Urgent Care, the Emergency Department, and in outpatient services. His is also helping to establish and augment a POCUS education program out of Orlando, and has taught POCUS for populations such as nurses, advanced practice providers, EMTs, and residents. Brandon visits Peru annually to work in community clinics around Trujillo and Ollantaytambo. In this role, he began introducing the concept of POCUS in the hopes of bringing greater services and access to populations with greater health disparities.

Brandon is a current Doctoral student as well, with the intention of building a more formalized and intensive POCUS program as part of his Doctoral project. As part of this, he recently published an article that speaks to the utility of POCUS, and how more disciplines should consider adopting it as part of their practice. Brandon’s wife is also currently in school to be a nurse practitioner, and has been dabbling with the use of ultrasound herself. Outside of Brandon’s medical roles, he and his wife spend a large amount of time traveling. They live in a rural area with a menagerie of dogs, cats, and chickens. Brandon is also a triathlete, currently training for an Ironman, and a snowboarder and snowmobiler in the winter.


Evaluating Muscle Trauma: POCUS as First Line Imaging



Alexander Talaska works as a radiologist in Vienna, focusing on musculoskeletal sonography in diagnostics and therapeutic interventions as well as emergency medicine. He loves the complexity of anatomical knowledge combined with dynamic scanning in MSK, solving a problem efficiently and integrating sonography in patients needs and best outcome in diagnostics. One of his favorites is peripheral nerve imaging. Already in the second year during his studies of medicine at the Medical University of Vienna (MUVI) he deeply got in touch with sonography. First teaching as a sono tutor from student to student, in between organizing the students initiative Sono4You on the same time while building up a team of enthusiastic students tutors in sonography besides his studies. In his radiology residency at the Department of Biomedical Imaging and Image-Guided Therapy at the MUVI he combined his broadly trained sonoanatomy skills with a huge variety of pathologies and MRI skills, especially in musculoskeletal imaging. Since 2012, Alex has contributed regularly to several teaching and educational events to medical specialists, residents, sonographers and medical students. He also focuses on comparable documentation techniques and structured reporting in sonography, interdisciplinary discussions and usage of sonography with consequence. At the moment Alex works in one of the biggest trauma and rehabilitation centers in Vienna, accompanied by sports medicine. He still enjoys teaching and passes on knowledge whenever he can.

Additional Resources

Read this article to learn how emergency physicians can use POCUS to visualize the structures beneath the skin.

Learn how musculoskeletal POCUS supplements the emergency physicians’ process of identifying the extent of an injury and the correct course of action.

The Point-of-care Ultrasound Diagnosis of Tennis Leg case study provides insights on why the portable, cost-effective nature of POCUS makes it an excellent modality for diagnosing a tear of the medial head of the gastrocnemius.


Minisode: Virtual Education Comes to POCUS World



 

Heesun Choi, DO, is an emergency medicine physician at the Department of Emergency Medicine Kingman Regional Medical Center where she serves as the Director of Emergency Ultrasound and the Director of EM Ultrasound Clerkship. Dr Choi is also an adjunct clinical assistant professor in the emergency medicine department at Medicine Midwestern University’s Arizona College of Osteopathic Medicine (AZCOM), an adjunct faculty instructor of ultrasound education at Touro University Nevada College of Osteopathic Medicine, and an assistant clinical professor in the University of California Irvine (UCI) Medical Center’s Department of Emergency Medicine.


Minisode: Experts Gear Up for POCUS World



 

Beshoy Ghaly, MD, is an ABPTS Board Certified Diplomate in Clinical Electrophysiology. He is also Registered in Musculoskeletal Sonography (RMSK) by the Alliance for Physician Certification and Advancement (APCA) and holds the Point-of-Care Ultrasound Musculoskeletal Certificate (POCUS). He has performed and interpreted thousands of diagnostic musculoskeletal ultrasound studies in both physical therapy and medicine practice settings, including the highly specialized orthopedic surgery field. He is an APTA-Credentialed Clinical Instructor, and has presented in professional conferences and published multiple journal articles related to the field. He serves the Academy of Clinical Electrophysiology and Wound Management as an elected Nominating Committee Member and an appointed Nominating Committee Chair of the Neuromusculoskeletal Ultrasonography Special Interest Group (NMSKUSSIG). He serves as an item writer for the Clinical Electrophysiology Board Exam through the ABPTS Specialization Academy of Content Experts. He is an active member of the American Institute of Ultrasound in Medicine & the American Physical Therapy Association. On a personal note, he is inspired by the incredible success & life stories of Elon Musk, Martin Luther King Jr, Helen Keller & Mahatma Gandhi.

Josh Davis, MD, is an emergency medicine physician in Wichita, Kansas. Dr. Davis received his medical degree from Jefferson Medical College and completed residency at Penn State Hershey Medical Center. He is also a certified personal trainer through the National Association of Sports Medicine.


A Lifetime of POCUS Learning



Arun Nagdev, M.D., is Exo’s Senior Director of Clinical Education. Separate from his capacity with Exo, he also serves as the Director of Emergency Ultrasound at Highland General Hospital as well as a Clinical Associate Professor of Emergency Medicine at University of California, San Francisco (UCSF). In his previous academic position, Dr. Nagdev started the point-of-care ultrasound (POCUS) program and fellowship at Brown University. Dr. Nagdev is a highly respected international POCUS researcher and educator. He has been a thought leader throughout his career, publishing more than 90 peer-reviewed papers on various aspects of POCUS including pain management, cardiac arrest and volume resuscitation. His work led to recognition and national awards at both the American College of Emergency Medicine (ACEP) and Society for Academic Emergency Medicine (SAEM). His desire to increase clinical POCUS education for residents and medical students has garnered him numerous teaching awards at Brown University, Highland Hospital and UCSF. Over the course of his career, he has been an invited lecturer for POCUS education at numerous national emergency medicine conferences (ACEP, SAEM, AAEM, etc). He currently serves as president of the American Institute of Ultrasound in Medicine (AIUM) POCUS section and is the incoming president for ACEP Ultrasound section.


Keep exploring point-of-care ultrasound at POCUS.org.


Physician Assistants Pursue POCUS Training



Nicole Reichhart, PA-C, is Assistant Professor and didactic faculty for the California State University, Monterey Bay Master of Science Physician Assistant program. She earned a Master of Science in Physician Assistant Studies from Albany Medical College in 2012 and completed an Emergency Medicine fellowship at Eastern Virginia Medical School in 2013. She has piloted a point-of-care ultrasound curriculum throughout the didactic phase of the MSPA program, preparing the students to enter their clinical year with a vast POCUS skillset. Nicole embeds POCUS into both the anatomy and physiology and clinical skills courses. She is passionate about implementing point-of-care ultrasound in physician assistant school curriculum and providing her students with opportunities to collaborate in the shared mission of improving global health and setting standards for excellence in POCUS. She has nine years of clinical experience as a PA, much of which has been in caring for patients in underserved communities. Nicole is a military spouse, mother of three children under 5, and enjoys a good brunch.


Overcoming POCUS Plateaus



Andre Kumar, MD, MEd, is a clinical assistant professor of internal medicine at Stanford University. He is the director for the Stanford Medicine Procedure Service, President of the Society of Hospital Medicine Bay Area, and an instructor for the Society of Hospital Medicine POCUS Certification Program. Dr. Kumar is passionate about researching POCUS for patient care and guiding future accreditation. He is currently the lead investigator for a multi-institutional study involving the use of POCUS for COVID-19, and he recently published two randomized trials investigating how to optimally train resident physicians with POCUS.

Resources

This study found that while a 2-day hands-on ultrasound course provides internal medicine physicians with an initial understanding of POCUS, there are barriers in transferring these abilities to clinical practice.

Find out how an interprofessional, near-peer workshop can help internal medicine residents develop POCUS skills, especially in programs where faculty expertise is limited.

Learn what will help residents overcome the barrier of unfamiliarity with documenting ultrasounds for diagnostic decision-making.

Discover how a phased implementation of POCUS curriculums has proven successful and could inform future educational programs.

Visit us at POCUS.org.


POCUS Augments Critical Care Nursing Diagnostics



Leon Chen, DNP, is a board certified acute care nurse practitioner with background in critical care medicine. He is the clinical program manager of research and simulated learning for the department of anesthesiology and critical care medicine at memorial Sloan Kettering cancer center, and a clinical assistant professor at NYU Rory Meyers College of Nursing. He is a strong proponent of utilizing point of care ultrasonography to rapidly delineate differential diagnoses and to guide resuscitation. Leon is also a fellow of the American College of Chest Physicians, the American Association of Nurse Practitioners, and the NY Academy of Medicine. He serves on the editorial board of Critical Care Nursing Quarterly and the Journal of American Association of Nurse Practitioners. He earned a certificate of completion in critical care ultrasonography from the American College of Chest Physicians and is active in point of care ultrasonography education.

 

Resources

Read this study about how nurses’ use of ultrasound enhanced the diagnostic process and level of care heart failure patients receive at an outpatient clinic.

Examine this review of 11 full-text publications and 10 conference abstracts found that patients experience positive benefits when renal nurses and technicians use POCUS. Learn more here.

Discover why the Canadian Association of Radiologists Position Statement on Point-of-Care Ultrasound also relates to nurse practitioners and other health care providers who use POCUS.