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Argirios Argiriou:
Published on 27 September 2021.
Briefing of the Euroson Pocus School Vienna, 10-11 September 2021 organized by EUVEKUS.
The Point of Care Ultrasonography is now an investigation in development, which can complement the physical examination of the family doctors and can guide the case management to the bedridden patients. We need training and quality standards, to ensure that this will be done in a way with positive benefits for our patients being useful to the implementation of ultrasound standards and practice guidelines of the primary care level. It involves personal contact between doctor and patient at "bedside", it is a fast in real-time method, repetitive, cheap, and harmless but dependent on the experience and expertise of the examiner. A new opportunity for PoC-US represents the application in primary care of the medical projects related to „telemedicine” connections among specialists and family doctors for enhanced patient management. The Educational Needs of GPs on the new methods and technologies are increasing, but the resources and infrastructure are limited now. It is thus necessary, the collaboration among the family physicians trainers, or academics, on the one hand, and the other, of the specialty physicians in the preparation and continuing medical education in family medicine. Early diagnosis can help to save many patients in primary care, based on notions of good clinical practice. Therefore, on the one hand, we will involve, to inform family physicians about the latest diagnostic and treatment protocols in POCUS, and on the other hand, we will launch a series of research projects in the field of clinical ultrasonography carried out by interested family doctors to emphasize the importance of this method.
After almost two years of online meetings, we managed to finally organize a regular meeting of Euroson POCUS School conducted by EUVEKUS (The European Ultrasound Working Group in Primary and Ambulatory Healthcare) under the auspices of EFSUMB and credited by EACCME, held in Vienna, Austria.
The conference venue was the University of Medicine of Vienna, within the building Universitätszahnklinik Wien and the artificial intelligence department, where we had the possibility and opportunity to have at our disposal several rooms (B1, B2, A2) and different amphitheaters in exceptional technical conditions, to support both our theoretical lectures presented by 12 international lecturers with expertise in the field of clinical ultrasonography, as well as the practical part of Hands-On workshops, on state-of-the-art and extremely high-performance devices dedicated to the primary healthcare section. We believe that it is very important to offer personal contacts and networking among our members, and although the epidemic is still quite active many of you have had the opportunity to physically join the conference.
The conference took place in hybrid form with more than 150 doctors present online, EUVEKUS accepting free online participation of young doctors under the age of 35, to promote POCUS in the younger family medicine and specialized outpatient medicine. We had at this event a number of 67 physically participating doctors, from various countries, namely: Austria, Romania, Israel, Germany, Switzerland, Italy, Poland, Croatia, Greece, Hungary, Spain, UK, Belgium, Kosovo, Serbia, Czech Republic, Moldova, and Bosnia-Herzegovina.
This was a special event in which practitioners of various specialties decided to participate in a significant number, meet old friends and make new ones, discuss the presentations and support the EUVEKUS.
Special thanks to our Keynote speakers who were the Presidents of three European organizations as Prof. Shlomo Vinker, the President of WONCA Europe (Israel), Prof. Christian Jenssen, the President of EFSUMB (Germany), and EUVEKUS President represented by Dr. Mihai IACOB as organizer and chairman of this true clinical ultrasonography marathon held over two days.
During this conference, we also had a one-hour round table in which the leaders of four medical international organizations (WONCA EUROPE, EFSUMB-the European Federation of Ultrasonography in Medicine and Biology, WFUMB - the Word Federation of Ultrasonography, and EUVEKUS) discussed the need and opportunity to introduce in the future Training Curriculum within the Family Medicine residency, which has a duration of 4 years in most European countries, of a new module of Clinical-Ultrasonography training for a period of 2-3 months to facilitate the use of this method in current practice. The conclusion of this debate was the fact that now when we have advanced and relatively cheap ultrasound devices, and high-performance technology with artificial intelligence with smart software using updated diagnostic algorithms, it's time to complete the classic clinical examination (by history, inspection, palpation, percussion, and auscultation) with the new clinical-ultrasound examination that currently allows us to visualize through ultrasound most organs and tissues of the human body(US-inspection), along with electronic ultrasound palpation through ultrasonographic elastography method, but also with the electronic auscultation through the Doppler Triplex technique. We support in the medium and long term the promotion of multimodal clinical ultrasonography in the current practice of outpatient medicine to increase the sensitivity, specificity, and diagnostic accuracy with the implicit decrease of costs in the current healthcare system. But for these desiderata, it is necessary standardization, modern guidelines for the practice of POCUS, but also continuous medical education and improvement, because ultrasonography is an addictive, cheap and repetitive operator method.
The main objective of EUVEKUS is the close collaboration with WONCA and EFSUMB to create a network platform for the professional training of family doctors at the European level through close participation and opening to POCUS uses in the daily practice of the WONCA Europe and its networks such as EGPRN (European General Practice Research Network), EURACT (European Academy of Teachers in Family Medicine), EQUIP, EURIPA, in which we are an integral part.
We thank all the international speakers, also to our sponsors in the field of ultrasonography (LIAMED Brasov, GE, Mindray, TRISO), but especially to all participants who were present in large numbers with us, and we will invite you to the next Euroson POCUS School Vienna 2022 Conference, which will take place on 9-10th September 2022, which we hope will become a traditional Euroson POCUS School for this topic.
Dr. Mihai IACOB, MD, Senior Medical Expert,
EUVEKUS President
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( Μίλησα με Έλληνα συνάδελφο που πήγε στο αντίστοιχο σεμινάριο τον Σεπτέμβριο του 2021. Πήγε με Ryanair, έμεινε σε κοντινό airbnb στο Πανεπιστήμιο της Βιέννης όπου έγινε το course, και η συνδρομή στο course ήταν περίπου 300 - 400 €. Υπήρχαν κάποιοι που το παρακολούθησαν διαδικτυακά αλλά πιστεύει ότι άξιζε που πήγε στο hands on course ).
Argirios Argiriou:
19 April 2022
How I Brought Point-of-Care Ultrasound (POCUS) to My Family Medicine Department
As I demonstrate a handheld ultrasound (US) machine to the eager medical students in our clinical simulation laboratory today, I am struck by a vivid recollection of my own first time seeing a handheld US machine. I was a 4th year medical student on an away rotation at a rural hospital in my home country of Peru. A visiting foreign obstetrician produced an amazing small machine, detecting fetal malposition when unsatisfied with palpation with Leopold’s maneuvers alone.
My fascination with the clinical utility of bedside US began that day and has continued through my move to US postgraduate training in family medicine, a geriatric medicine fellowship, academic faculty roles, the completion of an accredited POCUS fellowship, and right through to my current passion for growing POCUS use within family medicine practice.
I have learned so much along the way, have been helped by so many mentors and colleagues, that I write today to share my POCUS journey in the hopes that my story may be useful to others.
In 2018, I joined the department of Family Medicine at the University of Michigan in Ann Arbor (AAFP). The AAFP had recently released its novel POCUS curriculum guidelines for family medicine physicians, and the department was in search of a champion to lead the development of a POCUS program for our department. I was fortunate to be chosen for this role and over the intervening 3 years have had the privilege of working with several wonderful, enthusiastic colleagues across our department, our institution, and on a national scale through the AAFP’s POCUS interest group.
Early on in my role as POCUS champion, I realized that to be successful with this project, I was going to need a lot of help from a lot of people! My first stop (along a long journey) was to ask my department chair for time and resources. He readily obliged, providing me with the protected time to do an established accredited POCUS fellowship (which luckily was available through our emergency medicine department) and important administrative resources, which were also vital as we developed our program.
During my yearlong fellowship, I worked hard to become a clinical sonographer, educator, academic leader, and administrator in US. These newly acquired skills have been invaluable since assuming the role of Clinical US director for my department. There have been many challenges and administrative headaches—who knew that selecting and purchasing ultrasound machines could be so complicated?!?—but countless successes.
In terms of successes, we have defined minimum credentialing requirements for POCUS use, defined pathways for faculty interested in training in POCUS, and obtained hospital privileges for the same from our department. We have developed billing for our clinical POCUS use in ambulatory care as well as electronic health record order sets and templates for easy documentation. With regard to the POCUS curriculum that we initially set out to create, we now have a formal POCUS curriculum for family medicine residents as well as an intensive US track for residents interested in a more in-depth POCUS educational experience. Additionally, I am so excited that we will be welcoming our first Advanced Primary Care US fellow for a one-year fellowship this July.
It has not always been easy, but I have been so fortunate with wonderful supportive departmental leadership and fantastic emergency medicine colleagues who are always eager to help with advice on regulatory or administrative requirements. Developing the POCUS program for our department has taken a lot more time than I initially anticipated, and at times, the process has proved tedious. There certainly have been times when I have doubted if it has been worth the time and effort and doubted that colleagues share my vision for the potential POCUS offers for improving our patient care in family medicine or whether they see it as a burden, yet another thing to learn. However, the excitement I felt the first time I saw the handheld US those (many!) years ago in Peru, is reflected in the excitement I see in the faces of the medical students here in the clinical simulation lab today. This shared enthusiasm and passion for POCUS tells me that in the end, it truly will have been worth it.
Juana Nicoll Capizzano, MD, is a Clinical Assistant Professor and Clinical US Director of Family Medicine at Michigan University.
Interested in learning more about developing ultrasound education? Check out the following posts from the Scan:
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Argirios Argiriou:
Έλληνας Γενικός Ιατρός που το παρακολούθησε έμεινε ευχαριστημένος. Οι Τούρκοι ήθελαν επίσης συνεργασία με Έλληνες συναδέλφους:
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Argirios Argiriou:
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Argirios Argiriou:
Η Ελληνική Εταιρεία Επείγουσας Ιατρικής οργανώνει κατά καιρούς hands on courses στην χρήση υπερηχογράφου σε ΤΕΠ
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