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World Journal of Emergency Medicine ›› 2018, Vol. 9 ›› Issue (3): 216-222.doi: 10.5847/wjem.j.1920-8642.2018.03.009

• Original Articles • Previous Articles     Next Articles

Feasibility study of minimally trained medical students using the Rural Obstetrical Ultrasound Triage Exam (ROUTE) in rural Panama

Annasha Vyas1, Katherine Moran1, Joshua Livingston1, Savannah Gonzales1, Marlene Torres1, Ali Duffens1, Carina Mireles Romo1, Genevieve Mazza1, Briana Livingston2, Shadi Lahham3(), John Christian Fox3   

  1. 1 School of Medicine, University of California Irvine, Irvine, CA 92697, USA
    2 Department of Obstetrics and Gynecology, University of California Irvine, Orange, CA 92868, USA
    3 Department of Emergency Medicine, University of California Irvine, Orange, CA 92868, USA
  • Received:2018-01-09 Accepted:2018-04-02 Online:2018-09-15 Published:2018-09-15
  • Contact: Shadi Lahham E-mail:slahham@uci.edu

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Abstract:

BACKGROUND: Maternal and infant mortality rates reported in rural Panama are greater than those in urban regions. Bocas del Toro is a region of Panama inhabited by indigenous people at greater risk for pregnancy-related complications and deaths due to geographic isolation and limited access to health care. Portable ultrasound training programs have recently been implemented in low-resource settings to increase access to diagnostic imaging. The goal of this study is to determine the feasibility of teaching first-year medical students the Rural Obstetrical Ultrasound Triage Exam (ROUTE) to help identify pathology in pregnant women of the Bocas del Toro region of Panama.
METHODS: Eight first-year medical students completed ROUTE training sessions. After training, the students were compared to professional sonographers to evaluate their accuracy in performing the ROUTE. Students then performed the ROUTE in mobile clinics within Bocas del Toro. They enrolled women pregnant in their 2nd or 3rd trimesters and measured biparietal diameter, head circumference, amniotic fluid index, fetal lie and placental position. Any abnormal measurement would be further analyzed by the lead physician for a potential hospital referral.
RESULTS: A total of 60 women were enrolled in the study. Four women were detected as having a possible high-risk pregnancy and thus referred to a hospital for further evaluation.
CONCLUSION: Based on our data, first-year medical students with additional training can use the ROUTE to identify complications in pregnancy using ultrasound in rural Panama. Additional studies are required to determine the optimal amount of training required for proficiency.

Key words: Point of care ultrasound, Ultrasound education, Rural Panama, Obstetrics ultrasound