A5042236316- Ultrasound in Clinical Applications
- Emergency and Acute Care Studies
- Radiology practices and education
- Cerebral Venous Sinus Thrombosis
- Trauma and Emergency Care Studies
- Cardiac Arrest and Resuscitation
- Traumatic Brain Injury and Neurovascular Disturbances
- Disaster Response and Management
- Hemodynamic Monitoring and Therapy
- Climate Change and Health Impacts
- Global Maternal and Child Health
- Cardiac, Anesthesia and Surgical Outcomes
- Renal function and acid-base balance
- Global Health Workforce Issues
- Sepsis Diagnosis and Treatment
- Global Health and Surgery
- Viral gastroenteritis research and epidemiology
- Phonocardiography and Auscultation Techniques
- Maternal and fetal healthcare
- Pregnancy-related medical research
- Clinical Reasoning and Diagnostic Skills
- Simulation-Based Education in Healthcare
- Child Nutrition and Water Access
- Hip and Femur Fractures
- Marine and Coastal Research
Khyber Teaching Hospital
2025
Butterfly Conservation
2024
University of Washington
2013-2022
Johns Hopkins University
2018
Harborview Medical Center
2011-2018
Agency for Healthcare Research and Quality
2017
Virginia Tech
2017
University of Maryland, Baltimore
2017
University of Maryland, College Park
2017
Carilion Clinic
2017
Abstract Background: Measurements of the optic nerve sheath diameter (ONSD) using bedside ultrasound (US) have been shown to correlate with clinical and radiologic signs symptoms increased intracranial pressure (ICP). Objectives: Previous literature has identified 5 mm as ONSD measurement above which patients exhibit either or elevated ICP. The goals this study were evaluate association between ICP validate commonly used threshold direct measurements measured by ventriculostomy. Methods: A...
As portability and durability improve, bedside, clinician-performed ultrasound is seeing increasing use in rural, underdeveloped parts of the world. Physicians, nurses medical officers have demonstrated ability to perform interpret a large variety exams, growing body literature supports point-of-care developing nations. We review, by region, existing support world training guidelines currently use, highlight indications for emergency suggest future directions bedside research improve...
Access to ultrasound has increased significantly in resource-limited settings, including the developing world; however, there remains a lack of sonography education and ultrasound-trained physician support countries. To further investigate this potential knowledge gap, our primary objective was assess perceived barriers use settings by surveying care providers who practice low- middle-income settings.A 25-question online survey made available health work with an machine countries (LMICs),...
Over the last decade, utilization of ultrasound technology by non-radiologist physicians has grown. Recent advances in affordability, durability, and portability have brought to forefront as a sustainable high impact for use developing world clinical settings well. However, ultrasound's on patient management plans, program sustainability, which applications are useful this setting not been well studied. Ultrasound services were introduced at two rural Rwandan district hospitals affiliated...
Abstract Objectives: The objective of this study was to determine the test characteristics for two different ultrasound (US) measures severe dehydration in children (aorta inferior vena cava [IVC] ratio and IVC inspiratory collapse) one clinical measure (the World Health Organization [WHO] scale). Methods: authors enrolled a prospective cohort presenting with diarrhea and/or vomiting three rural Rwandan hospitals. Children were assessed clinically using WHO scale then underwent US by second...
Over the last decade, diffusion of ultrasound technology to nontraditional users has been rapid and far-reaching. Much research effort focused on developing an curriculum training practice guidelines for these users. The potential this diagnostic tool is not limited developed world in many respects adaptable resource international settings. However, needs-based development, guidelines, impact utilization, sustainability are well studied setting. We review one method introducing applicable...
To describe the outcomes and curriculum components of an educational programme to train non-physician clinicians working in a rural, Ugandan emergency department use POC ultrasound.The point-of-care ultrasound was taught care providers through lectures, bedsides teaching hands-on practical sessions. Lectures were tailored providers' knowledge base available therapeutic means. Every examination performed by these recorded over 4.5 years. Findings examinations categorised as positive,...
Summary Statement Simulation has had a major impact in the advancement of healthcare team training and assessment. To date, most simulation-based assessments focus on teamwork behaviors that performance, often ignoring critical cognitive, motivational, affective processes. Evidence from science research demonstrates strong relationship between cognition performance suggests role for simulation development this team-level construct. In article, we synthesize broader literature to provide...
Team situational awareness (TSA) is critical for effective teamwork and supports dynamic decision making in unpredictable, time-pressured situations. Simulation provides a platform developing assessing TSA, but these efforts are limited by suboptimal measurement approaches. The objective of this study was to develop evaluate novel approach TSA interprofessional emergency medicine (EM) teams.We performed multicenter, prospective, simulation-based observational an measurement....
Background: Early recognition of sepsis is a critical challenge in emergency medicine, particularly resource-constrained settings, where timely intervention essential to improve patient outcomes. Objective: This study aimed compare the effectiveness different Warning Scores (EWS), including National Score (NEWS), Modified (MEWS), quick Sequential Organ Failure Assessment (qSOFA), and Systemic Inflammatory Response Syndrome (SIRS), predicting outcomes such as mortality, ICU admission, septic...
Objective To prospectively validate three popular clinical dehydration scales and overall physician gestalt in children with vomiting or diarrhea relative to the criterion standard of percent weight change rehydration. Methods We enrolled a non-consecutive cohort ≤ 18 years age an acute episode vomiting. Patient weight, scale variables impression, gestalt, were recorded before after fluid resuscitation emergency department upon hospital discharge. The from presentation discharge was used...
Prior research suggests that the ratio of ultrasound-measured diameter inferior vena cava to aorta correlates with level dehydration in children. This study was designed externally validate this and access accuracy ultrasound measured inspiratory IVC collapse physician gestalt predict significant children emergency department. We prospectively enrolled a non-consecutive cohort ≤18 years old. Patient weight, measurements Ao, were recorded. The percent weight change from presentation discharge...
The purpose of the optic nerve sheath diameter (ONSD) research group project is to establish an individual patient-level database from high quality studies ONSD ultrasonography for detection raised intracranial pressure (ICP), and perform a systematic review patient data meta-analysis (IPDMA), which will provide cutoff value help physicians making decisions encourage further research. Previous meta-analyses were able assess diagnostic accuracy in detecting ICP but failed determine precise...
Many high-risk conditions of pregnancy are undetected until the time delivery in low-income countries. We developed a point-of-care ultrasound training protocol for providers rural Uganda to detect fetal distress or demise, malpresentation, multiple gestation, placenta previa, oligohydramnios and preterm delivery. This was mixed-methods study evaluate 2-week curriculum trainees' ability perform standard scanning interpret images. Surveys assess provider confidence were administered...
The diagnosis and management of acutely dyspneic patients in resource-limited developing world settings poses a particular challenge. Focused cardiopulmonary ultrasound (CPUS) may assist the emergency with acute dyspnea by identifying left ventricular systolic dysfunction, pericardial effusion, interstitial pulmonary edema, pleural effusion. We sought to assess accuracy providers performing CPUS after training intervention limited-resource setting; secondary objective was ability affect...
Lower respiratory tract infections (LRTIs) are the leading cause of deaths in children < 5 years old worldwide, particularly affecting low-resource settings such as Aweil, South Sudan. In these settings, diagnosis can be difficult because either lack access to radiography or clinical algorithms that overtreat with antibiotics who only have viral LRTIs. Point-of-care ultrasound (POCUS) has been applied LRTIs, but not by nonphysician clinicians, and limited data from settings. Our goal was...
The COVID-19 pandemic has spread to 185 countries with over 2.1 million confirmed cases and 145,000 deaths, as per the Johns Hopkins University dashboard provided at https://coronavirus.jhu.edu/map.html. Imaging modalities such chest radiography, thoracic cardiovascular ultrasound, computed tomography (CT) have roles in diagnosis, prognosis, monitoring, therapy of COVID-19. However, potential benefits imaging need be balanced against resource utilization infectious risk. Point-of-care...
Abstract Background Ultrasound is a crucial and effective diagnostic tool in medicine. Recent advancements technology have led to increased use of point-of-care ultrasound (POCUS). Access equipment training programs low-and middle-income countries (LMICs) limited. Despite the World Health Organization (WHO) recommendations for universal antenatal ultrasounds, POCUS reproductive health applications has not been widely used LMICs. We describe here feasibility implementation obstetrics (OB...