Have you ever watched the population clock? It is quite amazing how fast we are growing in numbers. As of today e.g. the U.S. has over 317 million people! Now, if you imagine the 85 million annual CT scans in this country, I hope you are quite as horrified as I am… The radiation exposure clock runs almost as fast. Thinking mathematically you would have to say that a fourth of the American population gets a yearly CT scan. In reality we have to account for the same individuals getting multiple CTs during one year, but it is still an astronomical number if you are asking me! Millions of lost opportunities to use ultrasound first . What’s even worse, according to a study published recently in JAMA Pediatrics, we are talking about “4 million pediatric CT scans of the head, abdomen/pelvis, chest, or spine performed each year”. Those are projected to cause about 4870 future cancers!
Please pardon my Disney fantasies, but we are talking about kids here! Nobody argues the beauty of the CT beast, and we all agree that in certain cases computer tomography is life-saving or inevitable. However, based on daily practice experience, I would say that quite a few of the 4 million CTs could have been ultrasound evaluations… The study authors plead for dose-reduction strategies. I think we all know an excellent one – it’s called “ultrasound first“!
Echoing Resa E Lewiss I would say that the field of pediatric EUS is wide open for disruptive innovations… Ooops, I meant, research inquiries . Let’s get to it – we have a lot of room for improvement and many cancers to prevent!
If you are not really sure where to start, I happen to have some suggestions. A few months ago I had a fascinating FaceTime conversation with Dr. Jason Fischer, Director of Emergency Ultrasound Program at SickKids in Toronto. Emergency medicine (EM), pediatric emergency medicine (PEM) and emergency ultrasound (EUS) trained in this very order. A man with a big heart for the little patients and a soft spot for emergency ultrasound education. Quite a passionate international evangelist of pediatric point-of-care ultrasonography (POCUS)!
Dr. Fischer runs an amazing ultrasound program in Toronto. He has been hiding it a little, but for a very good reason. His initial efforts were rightly focused on training the Canadian physicians. Now his PEM POCUS kingdom has widely opened its doors to international applicants. SickKids is quite unique in that aspect. Their dedication to worldwide education is admirable. They offer an unrivaled wealth of programs for international trainees and established physicians which you can explore at their website. If PEM POCUS is near and dear to your heart, and you want to make a difference for the little patients in your corner of the globe, I would not hesitate to get in touch with Dr. Fischer. I am sure he will think of a training solution quite tailored to your needs. It is your chance to get on board with making history. Without doubt, it is also the moment to embrace POCUS in your pediatric practice or it might hit you when you least expect it! The future is now and tomorrow begins today!