History of Point-of-Care Ultrasound (POCUS) in Sri Lanka

 

In 2013, the inaugural batch of Emergency Medicine trainees marked the beginning of POCUS utilization. It wasn't until 2019 that the first Emergency Physicians emerged. Over the years, 10 batches, comprising 200 trainees and 20 consultants, have participated. Despite lacking formal emergency sonography training until 2022, every EM trainee incorporated POCUS into their practice, recognizing its value as a cost-effective tool that could significantly enhance emergency care quality.


Faced with two options, importing accredited POCUS courses or instructors at a considerable cost or developing an in-house POCUS course tailored to the local system, the decision was made to pursue the latter. Opting to create a course aligned with global standards, several Emergency Physicians accredited in Emergency Sonography during overseas training in the UK/Australia conducted the introductory EM POCUS course from June 9-11, 2022, in Colombo. 


The 3-day course adheres to global standards, encompassing pre-course video materials, an online ultrasound physics module, discussion forums, and 20 hours of hands-on skills across 10 modules. Participants, selected from postgraduate trainees, consultants, and medical officers working in emergency and critical care settings, undergo a comprehensive training experience. Australian CCPU accredited Emergency Physicians are part of our faculty who immensely add value to the course. Due to overwhelming demand, the EM POCUS course is now conducted every three months. Stepping further, the first internationally recognised accreditation pathway for emergency sonography was established in 2022 in collaboration with POCUS Academy, USA and currently, around 15 trainees are under supervised training with EM POCUS Academy. 

 

The founding instructors of the EM POCUS course 

(Left to Right): Dr. Dilan Epasinghe, Dr. Harendra Cooray, Dr. S.K.A.D. Sanjeewa (Co-founder/Course Director/Supervisor for accreditation pathway/Sri Lankan Ambassador for POCUS Academy), Dr. Madurangi Ariyasinghe (Co-founder/Course Director/Supervisor for accreditation pathway/Founder and Chair of EM POCUS Academy), Dr. Bhaginda Gunawardena, Dr. Nuwan Warnakula, and Dr. Nandana Jayathilaka (President - SLCEP). Notably absent from the photo are Dr. Dushayantha Goonewardene, Dr. Bandara Ekanayake, Dr. Ganaja Samarajeewa, and Dr. T. Prasanth.

 

Introductory course – June 2022 in Colombo

 

Second course – December 2022, Colombo

Third course – March 2023, Colombo

Fourth course - June 2023, Kandy

 

In 2023, the Ultrasound chapter of the Sri Lanka College of Emergency Physicians (SLCEP) took a significant step by establishing the Emergency Medicine Point-of-Care Ultrasound (EM POCUS) Academy. This innovative initiative brings together Emergency Medicine Practitioners (EMPs) accredited in emergency sonography, overseas advisors, and trainee representatives. At the core of its activities, the EM POCUS Academy is administering an emergency sonography accreditation program. This program entails a local one-year supervised training period, coupled with an e-portfolio, and culminates in international accreditation from the POCUS Academy in the USA. Presently, close to 10 trainees are actively undergoing training for EM POCUS Accreditation.


Recognizing the vital need for well-trained doctors proficient in POCUS, the EM POCUS Academy, in collaboration with the Education, Training, and Research unit of the Ministry of Health, launched the inaugural island-wide training program in 2023. This program targets medical officers at the primary care level, offering a one-day Basic POCUS and a two-day Advanced POCUS course. This collaborative effort reflects the academy's commitment to extending the benefits of POCUS training across the healthcare landscape, emphasizing its importance in diverse medical settings.

 

First Basic POCUS course for Medical Officers – July 2023, Kalutara

Stepping further, as the first step to accredit the Anaesthesiology trainees, the POCUS for Anaesthesiology, the first 2-day course was successfully started in July 2023 in Kandy, and we were invited for more collaborations from other specialities in the near future. 

 

First POCUS for Anaesthesiology – June 2023, Kandy

To garner increased recognition and emphasize the significance of staying abreast of the latest developments in Point-of-Care Ultrasound (POCUS) beyond conventional practices, we take great pride in announcing our inaugural conference on Emergency Point of Care Ultrasound, icEM POCUS. This ground-breaking event took place at the Bandaranayake Memorial International Conference Hall (BMICH) in Colombo on the 2nd of December 2023. The conference featured the participation of global experts in the field, and attendees can benefit from five pre- and post-congress workshops covering emergency sonography in various specialized fields.

Our journey has been challenging, but the success we've achieved is a testament to the dedication and hard work of the members of the EM POCUS Academy. Our primary objective is to establish a standardized and updated emergency care system in Sri Lanka, with the vision of making the country a prominent training hub for emergency sonography in South Asia. We are diligently working towards this ambitious goal, driven by the commitment to elevate the standards of emergency care in the region.