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POCUS: Transforming the Future of Healthcare

“Treat every patient as if they were your mother or father because they are someone’s mother or father”. This is the patient care philosophy of Robert Kollpainter, a Physician Assistant (PA) at Aspirus Wausau Hospital.

He works with surgeons whose patients not only require but expect to receive the utmost care as they need a health turnaround. It is this philosophy and the vitality that Kollpainter places on patient care that motivates him to stay abreast of medical trends and advances.

Aspirus Wausau Hospital is a level 2 trauma center with a top-notch cardiac surgery program performing 350 to 400 cardiac surgery procedures annually. Also, Aspirus performs a significant number of procedures that range from chest tubes to thoracentesis, all impacted by the use of ultrasound.

The sheer volume of procedures performed, and Kollpainter’s unwillingness to compromise on the level of care he provides his patients, is what drove him to become an efficient user of point-of-care ultrasound (POCUS) in the hospital. “Thirteen years ago, we found ourselves unhappy with the process of obtaining PICC lines for our patients as we could not get our interventional radiologists to perform the procedure at the bedside. We were not willing to accept the risk of a critically ill patient, intubated, sedated and on vasoactive drips going to the other side of the hospital and down the stairs,” Kollpainter shares.

He was directed by his supervising physician to learn how to do POCUS himself. So, Kollpainter did just that. He dedicated himself to learning point-of-care ultrasound and did one better by earning his ARDMS credentials and becoming the first PA certified by the POCUS Certification Academy.

“We have had a critical care line service for about 12 years now, performing anywhere between 10 to 12 PICC lines a week, as well as ultrasound-guided arterial lines, central lines, and hemodialysis catheters at the bedside,” Kollpainter proudly explains.

At Aspirus, point-of-care ultrasound has made its most significant impact in the operating rooms of cardiac surgery.  In addition to evaluating conduit for myocardial revascularization veins, it assists care providers with arterial and femoral venous lines. “In the process of any cardiac surgical procedure, the patient will be completely anticoagulated,” Kollpainter explains, “Femoral line placement, particularly when anticoagulated, must be a one stick and done procedure. With ultrasound, we do not have complications. It is one and done every time. It has made a huge impact in that regard.”

The hospital is also starting a PA-POCUS internship program with six students being mentored through a year and a half course. The goal is when these students obtain their license to practice medicine, they will be ready to take on their POCUS examinations.

Kollpainter adds, “We love to teach. We believe in it. It makes us better providers. The relationships built from it are invaluable.”

The internship program is just one avenue Aspirus has to facilitate learning. The cardiology department at Aspirus is currently learning lung POCUS in an effort to strengthen its heart failure clinic. It believes that the data is very supportive regarding the use of POCUS in heart failure and strongly suggest that the use of ultrasound benefits in preventing readmission and provides overall better management of patients with congestive heart failure.

Aspirus is seeing the need and the future with a little help from Kollpainter. He is not shying away any time soon from being an advocate for point-of-care ultrasound and the positive impacts it is having on patient care.

“I believe strongly that this is the direction that medicine is moving. I just don’t believe I could ethically go back to practicing the way I did prior to POCUS,” says Kollpainter.

Do you agree? We would love to hear your thoughts on point-of-care ultrasound and how you believe it is changing the future of healthcare.

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