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Diagnostic point-of-care ultrasound in medical inpatients at Queen Elizabeth Central Hospital, Malawi: an observational study of practice and evaluation of implementation

Limani, Fumbani, Dula, Dingase, Keeley, Alexander, Joekes, Elizabeth, Phiri, Tamara, Tembo, Ephraim, Gadama, Luis, Nnensa, Victoria, Jordan, Sabine, Mallewa, Jane and Kreuels, Benno (2020) 'Diagnostic point-of-care ultrasound in medical inpatients at Queen Elizabeth Central Hospital, Malawi: an observational study of practice and evaluation of implementation'. Transactions of The Royal Society of Tropical Medicine and Hygiene. (In Press)

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Abstract

Background:
In less well-resourced settings, where access to radiology services is limited, point-of-care ultra-sound (POCUS) can be used to assess patients and guide clinical management. The aim of this study was to describe ultrasound practice in the assessment of medical inpatients at Queen Elizabeth Central Hospital, Blantyre, Malawi, and evaluate uptake and impact of POCUS following the introduction of a training programme at the college of Medicine, Blantyre, Malawi.

Methods:
A weekly prospective record review of sequential adult medical inpatients who had received an ultrasound examination was conducted.

Results:
Of 835 patients screened, 250 patients were included; 267 ultrasound examinations were performed,of which 133 (50%) were POCUS (defined as performed by a clinician at the bedside). The time from request toperformance of examination was shorter for POCUS examinations than radiology department ultrasound (RDUS)(median 0 [IQR 0–2, range 0–11] vs 2 [IQR 1–4, range 0–15] d, p=0.002); 104/133 (78.2%) POCUS and 90/133(67.7%) RDUS examinations were deemed to have an impact on management.

Conclusion:
Following the introduction of a training programme in POCUS, half of all ultrasound examinations were delivered as POCUS. POCUS was performed rapidly and impacted on patient management. POCUS may relieve the burden on radiology services in less well-resourced settings.

Item Type: Article
Subjects: WA Public Health > Health Problems of Special Population Groups > WA 395 Health in developing countries
WN Radiology. Diagnostic imaging > WN 180 Diagnostic imaging (General)
WX Hospitals and Other Health Facilities > WX 20 Research (General)
Faculty: Department: Clinical Sciences & International Health > Clinical Sciences Department
Digital Object Identifer (DOI): https://doi.org/10.1093/trstmh/traa137
Depositing User: Elly Wallis
Date Deposited: 11 Dec 2020 13:39
Last Modified: 04 Jun 2021 09:41
URI: https://archive.lstmed.ac.uk/id/eprint/16357

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