Why SonoStuff.com?

Three reasons:

As a co-director of technology enabled active learning (TEAL) at the UC Davis school of medicine I incorporate important technologies into the medical curriculum, which has primarily been point of care ultrasound (POCUS). Ultrasound is an incredible medical education tool and curriculum integration tool. It can be used to teach, reinforce, and expand lessons in anatomy, physiology, pathology, physical exam, and the list goes on.

I knew there was a better way to teach medical students thaschick_photo_1n standing in front of the classroom and giving a lecture. Student’s need to learn hands-on, spatial reasoning, and critical thinking skills to become excellent physicians. Teaching clinically relevant topics with ultrasound in small groups with individualized instruction
is the best strategy. I needed to flip the classroom.

I started by creating online lectures for an introduction to ultrasound lecture, thoracic anatomy, and abdominal anatomy:

Introduction to Ultrasound, POCUS

FAST Focused Assessment of Sonography in Trauma Part 1

FAST Focused Assessment of Sonography in Trauma Part 2

Aorta Exam AAA POCUS

Introduction in Cardiac Ultrasound POCUS

Topics quickly grew in scope and depth. I initially housed my lectures on YouTube and emailed them out to students before the ultrasound laboratory sessions. However, I wanted a platform that allowed for improved organization and showcasing. I needed a single oschick_photo_2nline resource they could go to to find those materials I was making specific to their medical curriculum.

https://www.youtube.com/channel/UCOhSjAZJnKpo8pP7ypvKDsw

Around the same time, during a weekly ultrasound quality assurance session in my emergency department I realized we were reviewing hundreds of scans each month and the reviewers were the only ones benefiting educationally from the process. Many cases were unique and important for education and patient care.

We began providing more feedback to our emergency sonographers and I decided I could use the same software I was using to develop material for the school of schick_photo_3medicine to highlight the most significant contributions to POCUS in our department every week. I quickly realized I needed a resource to house all these videos, one that anyone in my department could refer to when needed. The most efficient and creative method was to start a blog. I was discussing the project and possible names for the blog with colleagues and Dr. Sarah Medeiros said, “sounds like it’s a bunch of ultrasound stuff”. https://sonostuff.com was born.

I owe a great deal to free and open access to medical education or FOAMed. I was hungry for more POCUS education in residency and the ultrasoundpodcast.com came to the rescue. I became a local expert as a resident and even traveled to Tanzania to teach POCUS.

schick_photo_4I primarily began www.SonoStuff.com to organize and share with my department of emergency medicine and school of medicine, but it grew into a contribution to the growing body of amazing education resources that is FOAMed. I now use it as a resource in my global development work along with the many other FOAMed resources.

The work we all do in FOAMed, including AIUM’s the Scan, are an incredible and necessary resource. I have read the textbooks and attended the lectures, but I would not be where I am without FOAMed. I know all or most of those contributing to FOAMed do it out of love for education and patient care, without reimbursement or time off. Thank you to the many high-quality contributors and I am proud to play a small part in the FOAMed movement.schick_photo_5

Michael Schick, DO, MA, is Assistant Professor of Emergency Medicine at UC Davis Medical Center and Co-Director of Technology Enabled Active Learning, UC Davis School of Medicine. He is creator of www.sonostuff.com and can be reached on Twitter: ultrasoundstuff.

7 Tips for Scanning Overseas

So, you want to take that pretty little laptop ultrasound, put it into your backpack, and fly to parts unknown to help with patient care and/or to teach in a resource-limited setting? Not so fast, I say.

KuhnDonating or sharing your skills is a wonderful act and one that I highly recommend. But I don’t want you to end up on a 3-week scanning trip with nowhere to plug in your ultrasound machine and only 35 minutes left on your battery. It’s happened to me and it’s not pleasant. So below are some tips to consider if your next vacation finds you scanning in a remote village.

  1. The issue with electricity. There is a lot to consider when it comes to electricity. For starters, many countries have “rolling” power outages, which is a euphuism for no electricity when you need it most. How will you handle that situation? Oh, and don’t forget about voltage. Most machines will work on 110 or 220 volts, but I have had surges up to 400 volts. By the way, that is not good for ultrasound machines.
  2. Charging. How long does it take to charge your equipment? What about if you have to use solar power? And what if it’s rainy or you are scanning at night?
  3. How many tubes of gel do you need? I use about 1 tube per day per machine when scanning all day. Can you bring enough for your trip? If so, great. If not, do you make your own? Remember that homemade gel, while it does work, is of lower viscosity than commercial gel and gets very runny in the heat. Plus it smells like rotten vegetables after 1-2 days.
  4. Mind the heat. When you get hot, your machine gets hot. Use a cooling fan for both you and your machine when the ambient temperature is above 90 degrees Fahrenheit. If you need a break from the heat, give your machine a break as well and turn it off.
  5. What about the cold? Did you know that ultrasound probes are not engineered for cold temperatures? And when it gets below freezing image degradation is a problem. What do you do? Put those transducers and gel tubes into your pants pockets to keep them warm. Sure, you might get some strange looks, but the equipment and your patients will thank you.
  6. Do you want your teaching to leave a lasting impression? We all know that “the eye does not see what the mind does not know.” If you are looking to train people on your scanning vacation, you have to do what you have time to do. The key is to do what is best for the person you are training regardless of how much time you have. Make sure you have lots of hands-on and one-on-one time before you leave. Develop QA and QI plans in place before you leave or plan on multiple repeat visits to update and follow the progress of the person you are training.
  7. Avoid the bribe. What do you do if a customs official wants a $20,000 “deposit” before he will let you bring your machine into his country? The easiest first move is to tell him it’s just a laptop. We all know that most of the guts of ultrasound is in the probes. Luckily in many countries the customs officials have not figured that out yet–so don’t tell them. If this doesn’t work and you are not going to get out of the airport without a payoff, bond the machine. Bonding is a legal way of leaving your goods at the airport, and all airports around the world have a bonding process, which costs about $3 per day. Granted, you will have to leave your machine at the airport, but I have learned that there may be more to life than ultrasound!

Have you scanned in another country? What are your tips or suggestions? What have you learned from donating your skills? Comment below or let us know on Twitter: @AIUM_Ultrasound.

“Ted” Kuhn, MD, is professor of emergency medicine and professor of pediatrics at the Medical College of Georgia at Georgia Regents University. He, together with his wife, has lived and worked in Asia and led nearly 100 international medical trips.