Early Point of Care Ultrasound Training in Medical Education, Making the Case with a Case Report

Abstract

Background: Point of Care Ultrasound (PoCUS) emerged in the early 1990’s as a promising clinical and educational tool that allows for quicker diagnosis at the bedside. Our PoCUS program at Indiana University School of Medicine uniquely exposes students to training during their first weeks of medical school, with training continuing through all 4 years. Our paper demonstrates the portability and efficiency of PoCUS devices to benefit student run clinics, where vulnerable patients come to seek free medical care. Case: We report the case of a 48-year-old man presenting to our student run clinic with shortness of breath and cough. He recently immigrated from Nigeria, had no prior interaction with United States healthcare, and faced a significant language barrier. Physical examination conducted by the medical students revealed mild bibasilar crackles and 1+ pitting edema in the lower extremities. This prompted the students to suspect heart failure, and the first-year medical student used bedside ultrasound to reveal a reduced ejection fraction of approximately 15%, which resulted in expedited and escalated medical care. Conclusion: This case report demonstrates how incorporating PoCUS early into the undergraduate medical curriculum might improve patient care by expediting the diagnosis, while also enhancing student education. The use of bedside ultrasound rapidly updated the team to the severity and type of heart failure present. Therefore, the care team quickly escalated the appropriate treatment, and impressed the importance of follow up care to the patient.