Utilizing Point-Of-Care Ultrasound (POCUS) for Diagnosis in a Resource-Limited Setting: A Case Report of Pulmonary Embolism

POCUS for Diagnosis in a Resource-Limited Setting

Abstract

Introduction: Acute pulmonary embolism (PE) is a common cause of cardiovascular-related deaths and poses diagnostic challenges due to its variable and non-specific symptoms. Computed tomography pulmonary angiography (CTPA) is the gold standard imaging method for PE diagnosis, but its availability is limited in resource-constrained settings. Point-of-care ultrasound (POCUS) has emerged as a valuable tool for emergency physicians, aiding accurate diagnoses, procedural guidance, and resuscitation efforts.

Case Presentation: This case report presents a 76-year-old woman with non-specific symptoms diagnosed with PE using POCUS in the Emergency Department of the Korle Bu Teaching Hospital. The POCUS findings included an enlarged right ventricle with a flattened septum (D sign), poor cardiac contractility, thrombi in the right ventricle and a plethoric Inferior Vena Cava (IVC). Prompt diagnosis facilitated timely management, leading to improved patient outcomes.

Conclusion: POCUS has proven to be indispensable in resource-constrained settings where confirmatory diagnostics are limited. Incorporating POCUS training into emergency medicine residency programs and establishing emergency ultrasound fellowships in under-resourced regions like Africa can enhance its utilization and empower clinicians in such environments. Equipping emergency room clinicians with POCUS skills enables timely diagnosis, early interventions, shorter Emergency Department stays, and improved patient outcomes. This approach can contribute to building an African faculty proficient in emergency ultrasound, facilitating the education and training of more clinicians in POCUS, and ultimately enhancing healthcare outcomes in resource-limited environments.