Lung Ultrasound Training Program to Help Rural Emergency Medicine Providers Diagnose COVID-19 Patients

November 2, 2020
The tele-ultrasound training program for lung point-of-care ultrasound (POCUS) will enable rural emergency departments to more effectively identify and treat suspected COVID-19 patients.

TUCSON, Ariz. – The University of Arizona Health Sciences is developing a lung ultrasound education program for rural emergency medicine providers to better diagnose COVID-19.

Holding a bedside ultrasound device, Elaine Situ-LaCasse, MD, a UArizona College of Medicine –Tucson assistant professor and National Foundation of Emergency Medicine scholar, won a grant to train rural providers on lung ultrasound as a quicker, more efficient way to evaluate patients who may suffer from COVID-19. (Photo: University of Arizona Department of Health Sciences, Kris Hanning)Lung ultrasound can be particularly useful in rural emergency departments (EDs), as many lack CT scan capabilities or have limited access to COVID-19 testing. With the disparate impact of COVID-19 on rural populations in Arizona, it is important to expand use of the imaging tool across the state.

Elaine Situ-LaCasse, MD, an assistant professor in the Department of Emergency Medicine at the UArizona College of Medicine – Tucson and a scholar of the National Foundation of Emergency Medicine (NFoEM), is leading the effort to develop the ultrasound education program for rural emergency medicine providers.

“The ability to perform lung ultrasound could help rural physicians with screening, management and follow-up,” Dr. Situ-LaCasse said. “This tele-ultrasound education program would allow rural EM providers to connect with POCUS experts for education, image review, consultation and quality assurance.”

One of the rural sites participating in the program is Copper Queen Community Hospital in Bisbee, Arizona.

“As a critical care hospital, we often lack staff and resources but, despite these barriers, we strive to provide quality care to rural communities,” said Julia M. Brown, MD, the hospital’s Emergency Department medical director. “Our providers are excited to partner with Dr. Situ-Lacasse using state-of-the-art ultrasound to help diagnose and treat our patients.”

Dr. Elaine Situ-LaCasse (pictured here on the larger tablet device between the patient and physician) receives a live stream of the exam results and assists in diagnosing a mock patient during training via telehealth consultation with Julia Brown, MD (right), emergency department medical director at the Copper Queen Community Hospital in Bisbee, Arizona. (Photo: University of Arizona Health Sciences, Kris Hanning)

Lung ultrasound (LUS) plays a critical role in the COVID-19 pandemic. Evidence is mounting regarding its effectiveness to diagnose and assess the severity of coronavirus infections in hospital EDs. Sonographic features correlate well to computed tomography (CT) chest findings and a bedside LUS scan performed by a trained clinician, along with clinical examination, could be an alternative to chest X-ray and CT chest scans in these patients.

The project, “CLUE Study: A Tele-ultrasound Pilot Study in Rural Emergency Departments,” is funded by a NFoEM research grant. Upon completion of the CLUE (COVID-19 Lung Ultrasound Education) pilot study, Dr. Situ-LaCasse plans to expand the effort to a multi-center study that would include more rural EDs in other geographic regions of the United States. She also plans to expand this tele-ultrasound education platform to community EDs and other point-of-care ultrasound (POCUS) applications, such as cardiac ultrasound.

Dr. Situ-LaCasse will investigate the knowledge gap in rural emergency medicine providers’ use of lung ultrasound. Her research team will build upon various tele-ultrasound platforms to create a sustainable, reproducible and scalable tele-ultrasound education program to help rural ED physicians feel more comfortable performing lung ultrasounds in the diagnosis and management of suspected or confirmed COVID-19 patients.

Cristian Laguillo, MD, Copper Queen Community Hospital inpatient medicine director and a UArizona College of Medicine adjunct faculty member, discusses the bedside ultrasound machine with Julia Brown, MD, and Glenda Trevino, RN, nursing education director. (Photo: University of Arizona Health Sciences, Kris Hanning)

Dr. Situ-LaCasse is a part of NFoEM’s Scholar/Mentor Program, which provides an opportunity for scholars from 10 partner institutions to work on translational medicine research and foster professional development. She is one of nine scholar-mentor pairs receiving NFoEM funding for their COVID-19-related research projects. Her mentor is Srikar Adhikari, MD, a UArizona emergency medicine professor, Emergency Ultrasound Section chief and program director of the Emergency Ultrasound Fellowship.

Dr. Situ-LaCasse’s research team includes Dr. Adhikari; Josie Acuña, MD; Mimi Bach, MD; and Adrienne Yarnish, MD – who have completed or are in a one-year fellowship in emergency ultrasound performance, quality assurance, research and education, and have experience teaching a one-day in-person ultrasound course at the Native American and Rural Emergency Medicine Conference. They’re collaborating with Jarrod Mosier, MD, an NFoEM Scholar alumnus, UArizona emergency and internal medicine associate professor and associate program director of the college’s Critical Care Medicine Fellowship.

More information on the college’s activities regarding the COVID-19 pandemic is at this link.

The UArizona Health Sciences COVID-19 Research webpage can be found here.

For the latest on the UArizona response to the novel coronavirus, visit the COVID-19 webpage.

For UANews coverage of COVID-19, visit https://news.arizona.edu/news/covid19.

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NOTE: Photos available here – https://arizona.box.com/s/1hrf9ht9zgt0sr3zzysw37t2at1dm9kk.

About the University of Arizona College of Medicine – Tucson
The University of Arizona College of Medicine – Tucson is shaping the future of medicine through state-of-the-art medical education programs, groundbreaking research and advancements in patient care in Arizona and beyond. Founded in 1967, the college boasts more than 50 years of innovation, ranking among the top medical schools in the nation for research and primary care. Through the university's partnership with Banner Health, one of the largest nonprofit health care systems in the country, the college is leading the way in academic medicine. For more information, visit medicine.arizona.edu (Follow us: Facebook | Twitter | Instagram | LinkedIn).

About the University of Arizona Health Sciences
The University of Arizona Health Sciences is the statewide leader in biomedical research and health professions training. UArizona Health Sciences includes the Colleges of Medicine (Tucson and Phoenix), Nursing, Pharmacy, and the Mel and Enid Zuckerman College of Public Health, with main campus locations in Tucson and the Phoenix Biomedical Campus in downtown Phoenix. From these vantage points, Health Sciences reaches across the state of Arizona, the greater Southwest and around the world to provide next-generation education, research and outreach. A major economic engine, Health Sciences employs nearly 5,000 people, has approximately 4,000 students and 900 faculty members, and garners $200 million in research grants and contracts annually. For more information: uahs.arizona.edu (Follow us: Facebook | Twitter | YouTube | LinkedIn | Instagram).