The Impact of Systematic Point-of-Care Ultrasound on Management of Patients in a Resource-Limited Setting

Alastair Stanley London School of Hygiene and Tropical Medicine, London, United Kingdom.

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Bahati M. K. Wajanga Weill Bugando School of Medicine, Mwanza, Tanzania.

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Hyasinta Jaka Weill Bugando School of Medicine, Mwanza, Tanzania.

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Rachael Purcell London School of Hygiene and Tropical Medicine, London, United Kingdom.
School of Medicine, The University of Notre Dame Australia, Sydney, Australia.

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Lauren Byrne London School of Hygiene and Tropical Medicine, London, United Kingdom.

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Felicity Williams London School of Hygiene and Tropical Medicine, London, United Kingdom.

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Candace Rypien London School of Hygiene and Tropical Medicine, London, United Kingdom.

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Abigail Sharpe London School of Hygiene and Tropical Medicine, London, United Kingdom.

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Patrick Laws London School of Hygiene and Tropical Medicine, London, United Kingdom.

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Lucas Faustine London School of Hygiene and Tropical Medicine, London, United Kingdom.

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Tshepo Leeme London School of Hygiene and Tropical Medicine, London, United Kingdom.

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Emmanuel Mwabutwa London School of Hygiene and Tropical Medicine, London, United Kingdom.

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Robert Peck Weill Cornell Medical College, New York, New York.

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Matthew Stephens WellSpan York Hospital, York, Pennsylvania.

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Daniel Kaminstein Augusta University, Augusta, Georgia.

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Although target point-of-care (POC) ultrasonography has been shown to benefit patients in resource-limited settings, it is not clear whether a systematic POC ultrasound assessment in these settings can also lead to similar changes in patient management. A predefined systematic set of POC ultrasound scans were performed on inpatients at a tertiary referral hospital in Tanzania to see if this resulted in changes to patient management. Of the 55 patients scanned, an abnormality was detected in 75% (N = 41), and a change in patient management was recommended or implemented on the basis of POC ultrasound findings in 53% (N = 29). The main impact was earlier initiation of treatment due to more rapid and accurate diagnosis. Further research is warranted to determine whether systematic POC ultrasonography would result in improved patient outcomes in resource-limited settings.

Author Notes

* Address correspondence to Alastair Stanley, Bristol Royal Hospital for Children, Upper Maudlin Street, Bristol, BS2 8BJ, United Kingdom. E-mail: alastair.stanley@nhs.net

Authors' addresses: Alastair Stanley, Lauren Byrne, Felicity Williams, Candace Rypien, Abigail Sharpe, Patrick Laws, Lucas Faustine, Tshepo Leeme, and Emmanuel Mwabutwa, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom, E-mails: alastair.stanley@nhs.net, lauren.byrne@gmail.com, felicityjean.williams@gmail.com, candace.rypien@gmail.com, abi.sharpe@hotmail.com, pjlaws1@gmail.com, eben22003@gmail.com, tbleeme@yahoo.com, and emwabutwa@medcol.mw. Bahati M. K. Wajanga and Hyasinta Jaka, Department of Internal Medicine, Bugando Medical Centre, Mwanza, Tanzania, E-mails: wajangabmk@gmail.com and yasintaliwa5@gmail.com. Rachael Purcell, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom, and School of Medicine, University of Notre Dame Australia, Sydney, Australia, E-mail: rachael.purcell@gmail.com. Robert Peck, Department of Medicine, Weill Cornell Medical College, New York, NY, and Department of Internal Medicine, Bugando Medical Centre, Mwanza, Tanzania, E-mail: rnp2002@gmail.com. Matthew Stephens, Department of Emergency Medicine, WellSpan York Hospital, York, PA, E-mail: mstephens3@wellspan.org. Daniel Kaminstein, Department of Emergency Medicine, Georgia Regents University—Summerville Campus, Augusta, GA, E-mail: daniel.kaminstein@gmail.com.

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