Elliott Fox, MD
Elliott Fox, MD
Emergency Medicine · Worcester, MA

Angkor Hospital for Children POCUS Course

January 16th
Krong Siem Reap, Cambodia

Project Description

The University of Massachusetts Ultrasound Division is partnered with the Angkor Hospital for Children to teach ultrasound to Cambodian pediatric emergency medicine and intensivists. We have devised a longitudinal ultrasound curriculum to teach core EM and ICU ultrasound competencies. This involves virtual lectures over the course of the year from our ultrasound faculty followed by an in-person hands-on course in January 2023. The hands-on portion will consist of image capture and review with real-time in-person instruction and evaluation. As one of the current ultrasound fellows, I will be teaching during the hands-on portion. We hope that this will improve the care of pediatric patients in Cambodia particularly during dengue outbreaks by decreasing time to diagnosis, reducing radiation exposure and risk-stratifying patients at high risk for complications.

Population Served

The population who will benefit directly from this longitudinal ultrasound curriculum are twelve Cambodian pediatric emergency medicine physicians and pediatric ICU physicians. They have been participating in the online lectures, question-answer and testing portions of the course this fall and we hope to reinforce those concepts during the in-person session. Indirectly, there is a much broader population of pediatric patients in Cambodia who will benefit from the improved expertise of the physicians at the Angkor Hospital for Children.

Expected Impact

We anticipate that the twelve EM/ICU physicians will achieve competency as measured by: number of supervised scans, real-time in-person improvements, quizzes, and quality assurance provided both in-person and remotely. We follow the ACEP recommendations that a minimum of 25 scans in a particular application should be 100% quality-reviewed. Learning will carry forward after the in-person course by continued online sessions to provide spaced-repetition and image review.

Trip Photos & Recap

I traveled to Cambodia in January 2023 with UMass ultrasound faculty to teach point-of-care ultrasound to a group of pediatric physicians at Angkor Hospital for Children in Siem Reap. We created a virtual curriculum and delivered remote ultrasound lectures in the months leading up to the trip. Over the course of two weeks, we led small-group hands-on scanning sessions to teach both basic and advanced ultrasound applications, including: FAST, cardiac, renal, gallbladder, pulmonary, musculoskeletal, soft tissue and bowel. We scanned from nine in the morning until nine at night most days!

In addition to performing educational scans on models, the AHC physicians also asked us to assist them with clinical scans. We helped diagnose a ventricular septal defect in a neonate with a murmur. We also found a traumatic tibial fracture and expedited definitive orthopedic care. We even helped diagnose a patient with appendicitis who went to the operating room!

The virtual lectures will continue after our trip, both to provide spaced-repetition and to address more advanced topics in point-of-care ultrasound as we move forward. We hope to provide ongoing remote image review as well. Overall, it was a highly successful trip and we are excited to continue ongoing education with this enthusiastic group of doctors!