Background: Point-of-care ultrasound (POCUS) training in pediatrics varies greatly. The instructional-video training with the advancing technology of portable ultrasound machine is a novel method of POCUS training. Objective: We sought to investigate an effective, time-efficient method of POCUS training for pediatric hip effusion assessment; traditional in-person training (IPT) versus instructional-video training (IVT).
Methods: The study enrolled participants with no prior POCUS experience/training on hip effusion assessment. They were randomized to the IPT group or the IVT group. For the IPT group, a hands-on training session was provided with a skill assessment at the end of the session. As an efficacy measure of the training method, each participant’s ultrasound skill was classified into poor, good, or expert. For the IVT group, each participant was provided with an instructional video and a portable ultrasound machine for 5 days. The identical skill assessment was performed upon completion. Each participant logged the amount of time spent for the training.
Results: The study enrolled 12 participants. For the IPT group, all participants were trained in one of two group training sessions taking 80 minutes and 75 minutes, respectively. For the IVT group, the total time spent ranged from 30 minutes to 120 minutes with the average time of 71 minutes. All 6 participants from each group achieved expert level for the POCUS skill.
Conclusions: The study revealed that the instructional-video training with a portable ultrasound machine was as effective and time-efficient as the traditional in-person training but was less resource intensive.

A fifteen-year-old male presented with a purpuric rash of one-week duration. The rash began on his abdomen and spread to his extremities within two days. The patient received a course of prednisone; however, the rash progressed. He denied any recent medication changes, vaccinations, or arthropod exposure. Physical exam was significant for 3-5 mm monomorphic non-blanching purpuric papules on his abdomen, groin, and buttocks, with fewer lesions on his trunk and extremities (Figures 1, 2).

Group C and G streptococci, classified as Streptococcus dysgalactiae subsp. equisimilis(SDSE), are an unusual cause of sepsis in pediatric patients. SDSE have a similar pathogenicity to Streptococcus pyogenes, and can cause pharyngitis and skin and soft-tissue infections. Rarely, these organisms cause invasive disease including osteoarticular infections, bacteremia, and meningitis. In this report, we present two pediatric patients who were diagnosed with sepsis secondary to infection with group C and G streptococcus. Both were treated with penicillin G and recovered from the infection.