The University of Arizona Health Sciences is developing a lung ultrasound education program for rural emergency medicine providers to better diagnose COVID-19. 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,” Situ-LaCasse says. “This tele-ultrasound education program would allow rural EM providers to connect with [point-of-care ultrasound] 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, Ariz. “As a critical care hospital, we often lack staff and resources but, despite these barriers, we strive to provide quality care to rural communities,” says 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.”

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 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, 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 applications, such as cardiac ultrasound.

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.