Development of a Point-of-care Ultrasound Patient Safety Center of Inquiry for the Department of Veterans Affairs

Our faculty and investigators, along with a national network of point-of-care ultrasound experts, are teaming up with the VA National Center for Patient Safety to develop certification pathways and best practices in point-of-care ultrasound use for the VA system. The VA’s Point-of-care Ultrasound Patient Safety Center will be established at the South Texas Veterans Health Care System in San Antonio.


Evaluation of Implementation of a National Point-of-care Ultrasound Training Program

Since 2016, our point-of-care ultrasound faculty have served as national core faculty of the Department of Veterans Affairs’ Point-of-care Ultrasound Training program and are leading the quality improvement project evaluating the impact of training frontline clinicians in procedural and diagnostic POCUS applications on educational and clinical outcomes. This quality improvement project is funded by the VA’s Quality Enhancement Research Initiative (QUERI).


Clinical Evaluation of Personal Ultrasound System

In recent years, we have seen an explosion of personal handheld ultrasound devices used in clinical care as more clinicians have received point-of-care ultrasound training. We have partnered with various industry sponsors to fine tune ultrasound technology of handheld devices.  Currently, we have an ongoing product evaluation project with Vave Health.


Myocardial Scarring after Pneumococcal Sepsis

This novel translational science project focused on development of a non-human primate model to assess cardiac changes from pneumococcal sepsis. A multi-system point-of-care ultrasound exam was performed, and we demonstrated that lung ultrasonography accurately detected the consolidated lobes with pneumonia compared to the gold standard post-mortem pathological analysis.  This project was funded by the UT Health San Antonio Institute for Integration of Medicine and Science.


Pleural Fluid Echogenicity by Ultrasound Imaging and Computer Based Pixilation to Determine Transudative vs. Exudative Effusions

Artificial intelligence and computer-aided diagnosis are being integrated increasingly into point-of-care ultrasound technology.  This innovative protect compared qualitative versus quantitative assessments of pleural fluid echogenicity to differentiate transudative versus exudative effusions. We demonstrated that exudative effusions had higher pleural fluid echogenicity using computer-based pixel density and a pleural fluid ultrasound score can help differentiate exudative versus transudative pleural effusions.


National Survey of Point-of-care Ultrasound Use in VA Facilities

In collaboration with the VA Health Analysis and Information Group (HAIG), we conducted a large national survey of all VA medical centers to better understand the training needs, current use, and barriers to point-of-care ultrasound use. A key finding of this national survey was facilities that currently use point-of-care ultrasound had greater desire for additional training, and the greatest barriers to use were lack of training and limited access to ultrasound equipment. The initial survey was conducted in 2015 followed by a follow-up survey in 2020.


Pleural Ultrasonography to Rule out Post-bronchoscopy Pneumothorax

Although point-of-care pleural ultrasound can accurately rule out pneumothorax, we conducted this study to determine whether pleural ultrasound can accurately rule out pneumothorax in lung transplant recipients immediately post-bronchoscopy. We found that an immediate post-bronchoscopy pleural ultrasound exam can detect large pneumothoraces in lung transplant recipients that require prompt tube thoracostomy, but relatively slow air leaks leading to delayed pneumothoraces may be missed.


Use of Ultrasound for Central Venous Catheterization (US-CVC): A Multidisciplinary Survey of Physician Practices

Use of ultrasound guidance for central lines has been recommended by national patient safety organizations since the early 2000’s, but it has not been universally adopted into practice.  Our expert faculty group conducted a national survey of intensivists and hospitalists to assess the frequency of ultrasound use to guide insertion of central lines and explore the various provider, educational, and system barriers to use of ultrasound. We found that physicians least frequently used real-time ultrasound guidance to insert subclavian central lines, and limited access to an ultrasound machine and lack of training were the most significant barriers.

YearPublicationsPubmed Link
2021Haloot J, Soni NJ, Proud KC. 60-Year-Old Man With Liver Lesions and a Subcutaneous Nodule. Chest. 2021 Sep;160(3):e311-e313. doi: 10.1016/j.chest.2020.09.285. PMID: 34488974.Link
2021Soni NJ, Boyd JS, Mints G, Proud KC, Jensen TP, Liu G, Mathews BK, Schott CK, Kurian L, LoPresti CM, Andrus P, Nathanson R, Smith N, Haro EK, Mader MJ, Pugh J, Restrepo MI, Lucas BP. Comparison of in-person versus tele-ultrasound point-of-care ultrasound training during the COVID-19 pandemic. Ultrasound J. 2021 Sep 6;13(1):39. doi: 10.1186/s13089-021-00242-6. PMID: 34487262; PMCID: PMC8419826.Link
2021Soni NJ, Le MT, Velez MI, Proud KC. Incidental catheter-associated upper extremity deep venous thrombosis detected by point-of-care ultrasound. BMJ Case Rep. 2021 Aug 26;14(8):e244357. doi: 10.1136/bcr-2021-244357. PMID: 34446517.Link
2021Soni NJ, Winsett RE, Velez MI, Singhal P, Proud KC, Abedi A, Restrepo MI, Angel LF. Pleural Ultrasound for Detection of Postbronchoscopy Pneumothorax in Lung Transplant Recipients. J Bronchology Interv Pulmonol. 2021 Aug 10. doi: 10.1097/LBR.0000000000000799. Epub ahead of print. PMID: 34374670.Link
2021Maw AM, Ho PM, Morris MA, Glasgow RE, Huebschmann AG, Barnard JG, Metter R, Tierney DM, Mathews BK, Havranek EP, Kissler M, Fleshner M, Burian BK, Platz E, Soni NJ. Hospitalist Perceptions of Barriers to Lung Ultrasound Adoption in Diverse Hospital Environments. Diagnostics. 2021; 11(8):1451.
2021Maw AM, Morris MA, Barnard JG, Wilson J, Glasgow RE, Huebschmann AG, Soni NJ, Fleshner M, Kaufman J, Ho PM. Multi-Level Stakeholder Perspectives on Determinants of Point of Care Ultrasound Implementation in a US Academic Medical Center. Diagnostics (Basel). 2021 Jun 28;11(7):1172. doi: 10.3390/diagnostics11071172. PMID: 34203357; PMCID: PMC8305030.Link
2021Ibrahim S, Velez MI, Soni NJ, Proud KC. Delayed pneumothorax after transbronchial lung biopsy. BMJ Case Rep. 2021 Apr 5;14(4):e240985. doi: 10.1136/bcr-2020-240985. PMID: 33820805; PMCID: PMC8029879.Link
2021Su E, Soni NJ, Blaivas M, Bhargava V, Steffen K, Haileselassie B. Regulating Critical Care Ultrasound, It Is All in the Interpretation. Pediatr Crit Care Med. 2021 Apr 1;22(4):e253-e258. doi: 10.1097/PCC.0000000000002600. PMID: 33060421.Link
2021Mateos González M, García de Casasola Sánchez G, Muñoz FJT, Proud K, Lourdo D, Sander JV, Jaimes GEO, Mader M, Canora Lebrato J, Restrepo MI, Soni NJ. Comparison of Lung Ultrasound versus Chest X-ray for Detection of Pulmonary Infiltrates in COVID-19. Diagnostics (Basel). 2021 Feb 22;11(2):373. doi: 10.3390/diagnostics11020373. PMID: 33671699; PMCID: PMC7926899.Link
2021Schott CK, LoPresti CM, Boyd JS, Core M, Haro EK, Mader MJ, Pascual S, Finley EP, Lucas BP, Colon-Molero A, Restrepo MI, Pugh J, Soni NJ. Retention of Point-of-Care Ultrasound Skills Among Practicing Physicians: Findings of the VA National POCUS Training Program. Am J Med. 2021 Mar;134(3):391-399.e8. doi: 10.1016/j.amjmed.2020.08.008. Epub 2020 Sep 13. PMID: 32931765.Link
2020Maw AM, Huebschmann AG, Mould-Millman NK, Dempsey AF, Soni NJ. Point-of-Care Ultrasound and Modernization of the Bedside Assessment. J Grad Med Educ. 2020 Dec;12(6):661-665. doi: 10.4300/JGME-D-20-00216.1. Epub 2020 Dec 18. PMID: 33391586; PMCID: PMC7771602.Link
2020Adamson R, Morris AE, Sun Woan J, Ma IWY, Schnobrich D, Soni NJ. Development of a Focused Cardiac Ultrasound Image Acquisition Assessment Tool. ATS Sch. 2020 Jul 1;1(3):260-277. doi: 10.34197/ats-scholar.2020-0002OC. PMID: 33870293; PMCID: PMC8043312.Link
2020Proud KC, Beg M, Soni NJ. A 93-Year-Old Man With Submassive Pulmonary Embolism and Fall. Chest. 2020 Jul;158(1):e47-e50. doi: 10.1016/j.chest.2019.08.2213. Epub 2020 Jul 2. PMID: 32654739.Link
2020Maw A, Ortiz-Lopez C, Morris M, Jones CD, Gee E, Tchernodrinski S, Kramer HR, Galen B, Dempsey A, Soni NJ. Hospitalist Perspectives of Available Tests to Monitor Volume Status in Patients With Heart Failure: A Qualitative Study. Cureus. 2020 Jun 26;12(6):e8844. doi: 10.7759/cureus.8844. PMID: 32617243; PMCID: PMC7325405.Link
2020Mathews BK, Koenig S, Kurian L, Galen B, Mints G, Liu G, Soni NJ. Clinical Progress Note: Point-of-Care Ultrasound Applications in COVID-19. J Hosp Med. 2020 Jun;15(6):353-355. doi: 10.12788/jhm.3454. PMID: 32490807; PMCID: PMC7289505.Link
2020Salame G, Northcutt N, Soni NJ. Focused Cardiac Ultrasonography for Left Ventricular Systolic Function. N Engl J Med. 2020 Mar 5;382(10):976-977. doi: 10.1056/NEJMc2000059. PMID: 32130829.Link
2019Franco-Sadud R, Schnobrich D, Mathews BK, Candotti C, Abdel-Ghani S, Perez MG, Rodgers SC, Mader MJ, Haro EK, Dancel R, Cho J, Grikis L, Lucas BP; SHM Point-of-care Ultrasound Task Force, Soni NJ. Recommendations on the Use of Ultrasound Guidance for Central and Peripheral Vascular Access in Adults: A Position Statement of the Society of Hospital Medicine. J Hosp Med. 2019 Sep 6;14:E1-E22. doi: 10.12788/jhm.3287. Epub ahead of print. PMID: 31561287.Link
2019LoPresti CM, Boyd JS, Schott C, Core M, Lucas BP, Colon-Molero A, Kessler C, Mader MJ, Haro EK, Finley EP, Restrepo MI, Pugh J, Soni NJ. A National Needs Assessment of Point-of-Care Ultrasound Training for Hospitalists. Mayo Clin Proc. 2019 Sep;94(9):1910-1912. doi: 10.1016/j.mayocp.2019.07.016. Erratum in: Mayo Clin Proc. 2019 Dec;94(12):2597. PMID: 31486389.Link
2019Soni NJ, Franco-Sadud R, Kobaidze K, Schnobrich D, Salame G, Lenchus J, Kalidindi V, Mader MJ, Haro EK, Dancel R, Cho J, Grikis L; SHM Point-of-care Ultrasound Task Force, Lucas BP. Recommendations on the Use of Ultrasound Guidance for Adult Lumbar Puncture: A Position Statement of the Society of Hospital Medicine. J Hosp Med. 2019 Oct 1;14(10):591-601. doi: 10.12788/jhm.3197. Epub 2019 Jun 10. PMID: 31251163; PMCID: PMC6817310.Link
2019Villavicencio C, Leache J, Marin J, Oliva I, Rodriguez A, Bodí M, Soni NJ. Basic critical care echocardiography training of intensivists allows reproducible and reliable measurements of cardiac output. Ultrasound J. 2019 Apr 16;11(1):5. doi: 10.1186/s13089-019-0120-0. PMID: 31359188; PMCID: PMC6638616.Link
2019Maw AM, Hassanin A, Ho PM, McInnes MDF, Moss A, Juarez-Colunga E, Soni NJ, Miglioranza MH, Platz E, DeSanto K, Sertich AP, Salame G, Daugherty SL. Diagnostic Accuracy of Point-of-Care Lung Ultrasonography and Chest Radiography in Adults With Symptoms Suggestive of Acute Decompensated Heart Failure: A Systematic Review and Meta-analysis. JAMA Netw Open. 2019 Mar 1;2(3):e190703. doi: 10.1001/jamanetworkopen.2019.0703. PMID: 30874784; PMCID: PMC6484641.Link
2019Boyd JS, LoPresti CM, Core M, Schott C, Mader MJ, Lucas BP, Haro EK, Finley EP, Restrepo MI, Kessler C, Colon-Molero A, Pugh J, Soni NJ. Current use and training needs of point-of-care ultrasound in emergency departments: A national survey of VA hospitals. Am J Emerg Med. 2019 Sep;37(9):1794-1797. doi: 10.1016/j.ajem.2019.02.043. Epub 2019 Feb 28. PMID: 30878406.Link
2019Cho J, Jensen TP, Reierson K, Mathews BK, Bhagra A, Franco-Sadud R, Grikis L, Mader M, Dancel R, Lucas BP; Society of Hospital Medicine Point-of-care Ultrasound Task Force, Soni NJ. Recommendations on the Use of Ultrasound Guidance for Adult Abdominal Paracentesis: A Position Statement of the Society of Hospital Medicine. J Hosp Med. 2019 Jan 2;14:E7-E15. doi: 10.12788/jhm.3095. PMID: 30604780; PMCID: PMC8021127.Link
2019Soni NJ, Schnobrich D, Mathews BK, Tierney DM, Jensen TP, Dancel R, Cho J, Dversdal RK, Mints G, Bhagra A, Reierson K, Kurian LM, Liu GY, Candotti C, Boesch B, LoPresti CM, Lenchus J, Wong T, Johnson G, Maw AM, Franco-Sadud R, Lucas BP. Point-of-Care Ultrasound for Hospitalists: A Position Statement of the Society of Hospital Medicine. J Hosp Med. 2019 Jan 2;14:E1-E6. doi: 10.12788/jhm.3079. PMID: 30604779; PMCID: PMC8021128.Link
2018Yamada T, Minami T, Soni NJ, Hiraoka E, Takahashi H, Okubo T, Sato J. Skills acquisition for novice learners after a point-of-care ultrasound course: does clinical rank matter? BMC Med Educ. 2018 Aug 22;18(1):202. doi: 10.1186/s12909-018-1310-3. PMID: 30134975; PMCID: PMC6106885.Link
2018Morrow D, Cupp J, Schrift D, Nathanson R, Soni NJ. Point-of-Care Ultrasound in Established Settings. South Med J. 2018 Jul;111(7):373-381. doi: 10.14423/SMJ.0000000000000838. PMID: 29978220.Link
2018Maw AM, Soni NJ. Web Exclusives. Annals for Hospitalists Inpatient Notes - Why Should Hospitalists Use Point-of-Care Ultrasound? Ann Intern Med. 2018 Apr 17;168(8):HO2-HO3. doi: 10.7326/M18-0367. PMID: 29677272.Link
2018Dancel R, Schnobrich D, Puri N, Franco-Sadud R, Cho J, Grikis L, Lucas BP, El-Barbary M; Society of Hospital Medicine Point of Care Ultrasound Task Force, Soni NJ. Recommendations on the Use of Ultrasound Guidance for Adult Thoracentesis: A Position Statement of the Society of Hospital Medicine. J Hosp Med. 2018 Feb;13(2):126-135. doi: 10.12788/jhm.2940. PMID: 29377972.Link
2018Lucas BP, Tierney DM, Jensen TP, Dancel R, Cho J, El-Barbary M, Franco-Sadud R, Soni NJ; Society of Hospital Medicine Point-of-Care Ultrasound Task Force. Credentialing of Hospitalists in Ultrasound-Guided Bedside Procedures: A Position Statement of the Society of Hospital Medicine. J Hosp Med. 2018 Feb 1;13(2):117-125. doi: 10.12788/jhm.2917. Epub 2018 Jan 18. PMID: 29340341.Link
2017Jensen TP, Soni NJ, Tierney DM, Lucas BP. Hospital Privileging Practices for Bedside Procedures: A Survey of Hospitalist Experts. J Hosp Med. 2017 Oct;12(10):836-839. doi: 10.12788/jhm.2837. Epub 2017 Sep 6. PMID: 28991950.Link
2017Soni NJ, Tierney DM, Jensen TP, Lucas BP. Certification of Point-of-Care Ultrasound Competency. J Hosp Med. 2017 Sep;12(9):775-776. doi: 10.12788/jhm.2812. PMID: 28914287.Link
2017Reyes LF, Restrepo MI, Hinojosa CA, Soni NJ, Anzueto A, Babu BL, Gonzalez- Juarbe N, Rodriguez AH, Jimenez A, Chalmers JD, Aliberti S, Sibila O, Winter VT, Coalson JJ, Giavedoni LD, Dela Cruz CS, Waterer GW, Witzenrath M, Suttorp N, Dube PH, Orihuela CJ. Severe Pneumococcal Pneumonia Causes Acute Cardiac Toxicity and Subsequent Cardiac Remodeling. Am J Respir Crit Care Med. 2017 Sep 1;196(5):609-620. doi: 10.1164/rccm.201701-0104OC. PMID: 28614669; PMCID: PMC5620668.Link
2017Restrepo MI, Chalmers JD, Song Y, Mallow C, Hewlett J, Maldonado F, Yarmus L. Year in review 2016: Respiratory infections, acute respiratory distress syndrome, pleural diseases, lung cancer and interventional pulmonology. Respirology. 2017 Apr;22(3):602-611. doi: 10.1111/resp.13016. Epub 2017 Feb 28. PMID: 28244617; PMCID: PMC5889848.Link
2017Proud KC. Pulmonary embolism requiring intensive care: Do we now have a better idea of how to triage? Respirology. 2017 Feb;22(2):213-214. doi: 10.1111/resp.12973. PMID: 28102967.Link
2016Reyes LF, Restrepo MI, Hinojosa CA, Soni NJ, Shenoy AT, Gilley RP, Gonzalez- Juarbe N, Noda JR, Winter VT, de la Garza MA, Shade RE, Coalson JJ, Giavedoni LD, Anzueto A, Orihuela CJ. A Non-Human Primate Model of Severe Pneumococcal Pneumonia. PLoS One. 2016 Nov 17;11(11):e0166092. doi: 10.1371/journal.pone.0166092. PMID: 27855182; PMCID: PMC5113940.Link
2016Bhagra A, Tierney DM, Sekiguchi H, Soni NJ. Point-of-Care Ultrasonography for Primary Care Physicians and General Internists. Mayo Clin Proc. 2016 Dec;91(12):1811-1827. doi: 10.1016/j.mayocp.2016.08.023. Epub 2016 Nov 5. PMID: 27825617.Link
2016Aliberti S, Reyes LF, Faverio P, Sotgiu G, Dore S, Rodriguez AH, Soni NJ, Restrepo MI; GLIMP investigators. Global initiative for meticillin-resistant Staphylococcus aureus pneumonia (GLIMP): an international, observational cohort study. Lancet Infect Dis. 2016 Dec;16(12):1364-1376. doi: 10.1016/S1473-3099(16)30267-5. Epub 2016 Sep 1. Erratum in: Lancet Infect Dis. 2016 Dec;16(12):1324. PMID: 27593581.Link
2016Soni NJ, Franco-Sadud R, Schnobrich D, Dancel R, Tierney DM, Salame G, Restrepo MI, McHardy P. Ultrasound guidance for lumbar puncture. Neurol Clin Pract. 2016 Aug;6(4):358-368. doi: 10.1212/CPJ.0000000000000265. PMID: 27574571; PMCID: PMC4987119.Link
2016Soni NJ, Reyes LF, Keyt H, Arango A, Gelfond JA, Peters JI, Levine SM, Adams SG, Restrepo MI. Use of ultrasound guidance for central venous catheterization: a national survey of intensivists and hospitalists. J Crit Care. 2016 Dec;36:277-283. doi: 10.1016/j.jcrc.2016.07.014. Epub 2016 Jul 17. PMID: 27491563.Link
2016Cubo-Romano P, Torres-Macho J, Soni NJ, Reyes LF, Rodríguez-Almodóvar A, Fernández-Alonso JM, González-Davia R, Casas-Rojo JM, Restrepo MI, de Casasola GG. Admission inferior vena cava measurements are associated with mortality after hospitalization for acute decompensated heart failure. J Hosp Med. 2016 Nov;11(11):778-784. doi: 10.1002/jhm.2620. Epub 2016 Jun 6. PMID: 27264844.Link
2015Soni NJ, Franco R, Velez MI, Schnobrich D, Dancel R, Restrepo MI, Mayo PH. Ultrasound in the diagnosis and management of pleural effusions. J Hosp Med. 2015 Dec;10(12):811-6. doi: 10.1002/jhm.2434. Epub 2015 Jul 28. PMID: 26218493; PMCID: PMC4715558.Link
2015Soni NJ, Lucas BP. Diagnostic point-of-care ultrasound for hospitalists. J Hosp Med. 2015 Feb;10(2):120-4. doi: 10.1002/jhm.2285. Epub 2014 Nov 19. PMID: 25408226.Link