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Feasibility study of minimally trained medical students using the Rural Obstetrical Ultrasound Triage Exam(ROUTE)in rural Panama

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World Journal of Emergency Medicine 2018年第3期9卷 216-222页

作者： Annasha Vyas Katherine Moran Joshua Livingston Savannah Gonzales Marlene Torres Ali Duffens carina mireles romo Gnevieve Mazza Briana Livingston Shadi Lahham John Christian Fox School of Medicine University of California IrvineIrvineCA 92697USA Department of Obstetrics and Gynecology University of California IrvineOrangeCA 92868USA Department of Emergency Medicine University of California IrvineOrangeCA 92868USA

BACKGROUND:Maternal and infant mortality rates reported in rural Panama are greater than those in urban *** del Toro is a region of Panama inhabited by indigenous people at greater risk for pregnancy-related complications and deaths due to geographic isolation and limited access to health *** ultrasound training programs have recently been implemented in low-resource settings to increase access to diagnostic *** goal of this study is to determine the feasibility of teaching firstyear medical students the Rural Obstetrical Ultrasound Triage Exam(ROUTE)to help identify pathology in pregnant women of the Bocas del Toro region of ***:Eight first-year medical students completed ROUTE training *** training,the students were compared to professional sonographers to evaluate their accuracy in performing the *** then performed the ROUTE in mobile clinics within Bocas del *** enrolled women pregnant in their 2nd or 3rd trimesters and measured biparietal diameter,head circumference,amniotic fluid index,fetal lie and placental *** abnormal measurement would be further analyzed by the lead physician for a potential hospital ***:A total of 60 women were enrolled in the *** women were detected as having a possible high-risk pregnancy and thus referred to a hospital for further ***:Based on our data,first-year medical students with additional training can use the ROUTE to identify complications in pregnancy using ultrasound in rural *** studies are required to determine the optimal amount of training required for proficiency.

关键词： Point of care ultrasound Ultrasound education Rural Panama Obstetrics ultrasound

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Assessment of clinical dehydration using point of care ultrasound for pediatric patients in rural Panama

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World Journal of Emergency Medicine 2019年第1期10卷 46-50页

作者： Genevieve Mazza carina mireles romo Marlene Torres Ali Duffens Annasha Vyas Katherine Moran Joshua Livingston Savannah Gonzales Shadi Lahham Inna Shniter Maxwell Thompson John Christian Fox School of Medicine University of California Irvine Department of Emergency Medicine University of California Irvine

BACKGROUND: Dehydration and its associated symptoms are among the most common chief complaints of children in rural Panama. Previous studies have shown that intravascular volume correlates to the ratio of the diameters of the inferior vena cava(IVC) to the aorta(Ao). Our study aims to determine if medical students can detect pediatric dehydration using ultrasound on patients in rural Panama. METHODS: This was a prospective, observational study conducted in the Bocas del Toro region of rural Panama. Children between the ages of 1 to 15 years presenting with diarrhea, vomiting, or parasitic infection were enrolled in the study. Ultrasound measurements of the diameters of the IVC and abdominal aorta were taken to assess for dehydration. RESULTS: A total of 59 patients were enrolled in this study. Twenty-four patients were clinically diagnosed with dehydration and 35 were classified to have normal hydration status. Of the 24 patients with dehydration, half(n=12) of these patients had an IVC/Ao ratio below the American threshold of 0.8. Of the remaining asymptomatic subjects, about half(n=18) of these subjects also had an IVC/Ao ratio below the American threshold of ***: Our study did not support previous literature showing that the IVC/Ao ratio is lower in children with dehydration. It is possible that the American standard for evaluating clinical dehydration is not compatible with the rural pediatric populations of Panama.

关键词： Ultrasound Parasitic infection Panama Rural medicine Dehydration Medical education

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