Is Northern Ontario School of Medicine there yet? Peter Hutten-Czapski Canadian Journal of Rural Medicine 2019 24(4):103-103

L'ÉMNO y est-elle arrivée? Peter Hutten-Czapski Canadian Journal of Rural Medicine 2019 24(4):104-104

President's message. Access or continuity? Margaret Tromp Canadian Journal of Rural Medicine 2019 24(4):105-105

Message du Président. Accès ou continuité? Margaret Tromp Canadian Journal of Rural Medicine 2019 24(4):106-106

Physician attendance during interhospital patient transfer Beuy Joob, Viroj Wiwanitkit Canadian Journal of Rural Medicine 2019 24(4):107-107

Authors' Reply David Wonnacott Canadian Journal of Rural Medicine 2019 24(4):108-108

Use of point-of-care ultrasound for the assessment of intravascular volume in five rural New Zealand hospitals Garry Nixon, Katharina Blattner, Wendy Finnie, Ross Lawrenson, Ngaire Kerse Canadian Journal of Rural Medicine 2019 24(4):109-114 Introduction: Measuring the diameter of the inferior vena cava (IVC) or the height of the jugular venous pressure (JVP) with point-of-care ultrasound (POCUS) is a practical alternative method for estimating a patient's intravascular volume in the rural setting. This study aims to determine whether or not POCUS of the IVC or JVP generates additional useful clinical information over and above routine physical examination in this context. Methods: Twenty generalist physicians, working in five New Zealand rural hospitals, recorded their estimation of a patient's intravascular volume based on physical examination and then again after performing POCUS of the IVC or JVP, using a visual scale from 1 to 11. Results: Data were available for 150 assessments. There was an only moderate agreement between the pre- and post-test findings (Spearman's correlation coefficient = 0.46). In 28% (42/150) of cases, the difference was four or more points on the scale, and therefore, had the potential to be clinically significant. Conclusion: In the rural context, POCUS provides new information that frequently alters the clinician's estimation of a patient's intravascular volume.

Project ECHO: Building capacity to manage complex conditions in rural, remote and underserved areas Andrea D Furlan, Kathleen A Pajer, William Gardner, Bryan MacLeod Canadian Journal of Rural Medicine 2019 24(4):115-120 There is a need to bring specialized medical expertise to rural and remote areas. Project ECHO offers a method to move knowledge from specialists in academic centres using videoconference, case-base learning, and best-practices knowledge sharing. Ontario has implemented ECHO since 2014 and has demonstrated favourable outcomes among primary care clinicians.

Country cardiograms case #66 Charles William Helm Canadian Journal of Rural Medicine 2019 24(4):121-121

Country cardiograms case #66: Answer Charles William Helm Canadian Journal of Rural Medicine 2019 24(4):122-122