Creation of a High‐fidelity,Low‐cost Pediatric Skull Fracture Ultrasound Phantom

Over the past decade, point‐of‐care ultrasound has become a common tool used for both procedures and diagnosis. Developing high‐fidelity phantoms is critical for training in new and novel point‐of‐care ultrasound applications. Detecting skull fractures on ultrasound imaging in the younger‐than‐2‐year‐old patient is an emerging area of point‐of‐care ultrasound research. Identifying a skull fracture on ultrasound imaging in this age group requires knowledge of the appearance and location of sutures to distinguish them from fractures. There are currently no commercially available pediatric skull fracture models. We outline a novel approach to building a cost‐effective, simple, high‐fidelity pediatric skull fracture phantom to meet a unique training requirement.     

A Novel Low‐Cost Ultrasound‐Guided Pericardiocentesis Simulation Model: Demonstration of Feasibility

Pericardiocentesis is a rare life‐saving procedure for patients with cardiac tamponade. Due to the infrequency of this procedure, simulation models are often used for training. Commercial models are generally expensive. Proposed homemade models offer a lower‐cost alternative but can be labor and time intensive. The purpose of this study was to determine the feasibility of a limited use, low‐cost ultrasound‐guided pericardiocentesis model as a training tool for emergency physicians. Our model proved to be a practical, easily implemented, and acceptable model for training emergency physicians, including residents and students, in ultrasound‐guided pericardiocentesis.     

An Inexpensive and Easy Ultrasound Phantom

Ultrasound models, commonly referred to as “phantoms,” are simulation tools for ultrasound education. Commercially produced phantoms are available, but there are “homemade” alternatives such as raw poultry and gelatin molds. Precooked, processed meat, better known as SPAM (Hormel Foods Corporation, Austin, MN), can be used as an ultrasound phantom to teach several ultrasound applications. It is a versatile, hygienic, and easily manipulated medium that does not require refrigeration or preparatory work and can be easily discarded at the end of use.     

Point‐of‐Care Ultrasound in General Surgery Residency Training: A Proposal for Milestones in Graduate Medical Education Ultrasound

The use of point‐of‐care ultrasound (US) in the clinical setting has undergone massive growth, although its incorporation into training and practice is variable. Surgeons are interested in using point‐of‐care US and can incorporate it effectively into clinical practice. However, the current state of point‐of‐care US training in general surgery is inadequate. The Accreditation Council for Graduate Medical Education introduced the Milestones Project to evaluate resident and fellow performance. Emergency medicine is the only specialty with a point‐of‐care US milestone. We have successfully implemented a US training program into our general surgery residency curriculum and now propose milestones in point‐of‐care US for all general surgery residents.     

Economical Sponge Phantom for Teaching,Understanding, and Researching A‐ and B‐Line Reverberation Artifacts in Lung Ultrasound

This project evaluated a low‐cost sponge phantom setup for its capability to teach and study A‐ and B‐line reverberation artifacts known from lung ultrasound and to numerically simulate sound wave interaction with the phantom using a finite‐difference time‐domain (FDTD) model. Both A‐ and B‐line artifacts were reproducible on B‐mode ultrasound imaging as well as in the FDTD‐based simulation. The phantom was found to be an easy‐to‐set up and economical tool for understanding, teaching, and researching A‐ and B‐line artifacts occurring in lung ultrasound. The FDTD method–based simulation was able to reproduce the artifacts and provides intuitive insight into the underlying physics.     

A Cost‐effective,Gelatin‐Based Phantom Model for Learning Ultrasound‐Guided Fine‐Needle Aspiration Procedures of the Head and Neck

The rise in popularity of ultrasound imaging has seen a corresponding increase in demand for effective training tools such as phantom models. They are especially useful for teaching and practice of invasive procedures, such as fine‐needle aspiration of lesions of the head and neck. We have created 2 gelatin models out of inexpensive, commonly available materials that can be used in sequence to learn head and neck fine‐needle aspiration. Fundamental skills can be learned first on the flat, rectangular model, whereas the second, cylindrical model more closely represents human anatomy and can be used to develop more advanced technique.     

Point‐of‐Care Ultrasound Findings Associated With Langerhans Cell Histiocytosis in the Pediatric Emergency Department

Langerhans cell histiocytosis is a rare disease characterized by clonal proliferation of Langerhans‐type cells, causing local or systemic effects. One of the most affected sites in children is the skull. We describe 2 cases of children presenting to the pediatric emergency department with symptoms isolated to the scalp and the point‐of‐care focused skull ultrasound findings, which assisted in the diagnosis of Langerhans cell histiocytosis in both cases.     

A Primary Care Ultrasound Fellowship: Training for Clinical Practice and Future Educators

As ultrasound devices become smaller, more portable, and more user friendly, there is now widespread use of this technology by physicians of all specialties, yet there are currently few structured opportunities for ultrasound education outside of emergency and critical care medicine. Anticipating the rising educational demand in the primary care specialties, the University of South Carolina School of Medicine created a primary care ultrasound fellowship in 2011, the first yearlong training program in point‐of‐care ultrasonography for graduates of internal medicine, medicine‐pediatrics, pediatrics, and family medicine residencies. This paper reviews the history of point‐of‐care ultrasonography fellowships and then provides an overview of the primary care ultrasound fellowship.     

Point‐of‐Care Ultrasound as a Component of Preparticipation Screening of Athletes: A Systematic Review

This review examined whether the addition of point‐of‐care ultrasound (POCUS) to electrocardiography (ECG)‐inclusive preparticipation screening strategies has the potential to reduce false‐positive results and detect diseases associated with sudden cardiac death that may not be identified through current modalities. Five studies, representing 2646 athletes, demonstrated that ECG‐inclusive preparticipation screening strategies resulted in positive results in 19.9% of the cohort. With the addition of POCUS, positive results were reduced to 4.9%, and 1 additional condition potentially associated with sudden cardiac death was identified. The magnitude of positive results with POCUS may be reduced if current ECG criteria were applied.     

Advantages of Cardiopulmonary Ultrasound in Post–Cardiopulmonary Resuscitation Tension Pneumothorax

Tension pneumothorax is a life‐threatening condition that frequently occurs in the setting of cardiopulmonary resuscitation as a result of positive pressure ventilation and chest compressions. Developing crepitus due to subcutaneous air can severely limit pleural ultrasound (US) views and hinder the diagnosis of pneumothorax by pleural US. Physicians trained in the use of point‐of‐care US must be familiar with the subcostal cardiac and inferior vena cava views associated with tension pneumothorax. These include a dilated, nondistensible inferior vena cava and hyperdynamic right heart as a result of a reduced preload.     

Enhanced Point‐of‐Care Ultrasound Applications by Integrating Automated Feature‐Learning Systems Using Deep Learning

Recent applications of artificial intelligence (AI) and deep learning (DL) in health care include enhanced diagnostic imaging modalities to support clinical decisions and improve patients’ outcomes. Focused on using automated DL‐based systems to improve point‐of‐care ultrasound (POCUS), we look at DL‐based automation as a key field in expanding and improving POCUS applications in various clinical settings. A promising additional value would be the ability to automate training model selections for teaching POCUS to medical trainees and novice sonologists. The diversity of POCUS applications and ultrasound equipment, each requiring specialized AI models and domain expertise, limits the use of DL as a generic solution. In this article, we highlight the most advanced potential applications of AI in POCUS tailored to high‐yield models in automated image interpretations, with the premise of improving the accuracy and efficacy of POCUS scans.