Unable to speak and essentially paralyzed, a 16-year-old girl arrived at a rural hospital in eastern Rwanda. Clinicians used an ultrasound machine to perform an echocardiogram—a sonogram of her heart—to diagnose that she had suffered a stroke.  At another hospital in northern Rwanda, 3-month-old baby boy arrived suffering from a painfully swollen leg. An ultrasound helped clinicians make the diagnosis—a hematoma, or mass of clotted blood—most likely caused by the needle from a recent vaccination. Knowing the cause, hospital staff were able to quickly begin providing treatment for both patients.

As ultrasound machines become more durable, portable, lightweight and affordable, they are fast becoming the vital diagnostic tools for even the most rural of PIH’s hospitals.

As the equipment becomes available, PIH and its partners have been working hard to train staff on the use of these machines. As part of this effort, PIH has recently published The Manual of Ultrasound for Resource-Limited Settings. This manual, developed by a team of PIH clinicians led by Dr. Sachita Shah, is a concise review of bedside, clinician-performed ultrasound, with focus on specific diagnostic questions and disease processes common in the developing world.

"We wanted to create a free resource that providers could use in places where access to formal sonography and radiologists is extremely limited,” says Dr. Shah. “The manual covers clinician-performed ultrasound as it is used for common diagnostic dilemmas such as: Does my patient with shortness of breath have heart failure or fluid around the heart? Is this trauma patient bleeding internally? and Is this fetus breech? As clinicians working in resource poor settings know, the right answers to these questions can save a patient's life, and ultrasound, in trained hands, is an invaluable tool for speedy and accurate diagnosis of life-threatening conditions."

In addition to diagrams and basic how-to information, it also includes case studies from PIH’s partners in Rwanda, Haiti, and Burundi.

Already in use by PIH’s team in Rwanda, the manual has been used for trainings at several of PIH’s sites in Haiti, as well as for trainings by other organizations in Uganda, Kenya, and Ghana.

The Manual of Ultrasound for Resource-Limited Settings is now available as a free download from PIH’s website.


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