scholarly journals Point-of-care ultrasound (POCUS) practices in the helicopter emergency medical services in Europe: results of an online survey

2021 ◽  
Vol 29 (1) ◽  
Author(s):  
Peter Hilbert-Carius ◽  
Manuel F. Struck ◽  
Marcus Rudolph ◽  
Jürgen Knapp ◽  
Leif Rognås ◽  
...  
Keyword(s):  
Emergency Medical Services ◽  
Online Survey ◽  
Point Of Care ◽  
Expert Committee ◽  
Point Of Care Ultrasound ◽  
Trauma Patients ◽  
Web Portal ◽  
Medical Directors ◽  
Near Future ◽  
Online Web

Abstract Background The extent to which Point-of-care of ultrasound (POCUS) is used in different European helicopter EMS (HEMS) is unknown. We aimed to study the availability, perception, and future aspects of POCUS in the European HEMS using an online survey. Method A survey about the use of POCUS in HEMS was conducted by a multinational steering expert committee and was carried out from November 30, 2020 to December 30, 2020 via an online web portal. Invitations for participation were sent via email to the medical directors of the European HEMS organizations including two reminding notes. Results During the study period, 69 participants from 25 countries and 41 different HEMS providers took part in the survey. 96% (n = 66) completed the survey. POCUS was available in 75% (56% always when needed and 19% occasionally) of the responding HEMS organizations. 17% were planning to establish POCUS in the near future. Responders who provided POCUS used it in approximately 15% of the patients. Participants thought that POCUS is important in both trauma and non-trauma-patients (73%, n = 46). The extended focused assessment sonography for trauma (eFAST) protocol (77%) was the most common protocol used. A POCUS credentialing process including documented examinations was requested in less than one third of the HEMS organizations. Conclusions The majority of the HEMS organizations in Europe are able to provide different POCUS protocols in their services. The most used POCUS protocols were eFAST, FATE and RUSH. Despite the enthusiasm for POCUS, comprehensive training and clear credentialing processes are not available in about two thirds of the European HEMS organizations. Due to several limitations of this survey further studies are needed to evaluate POCUS in HEMS.

scholarly journals ​Point-of-Care Ultrasound (POCUS) practices in the Helicopter Emergency Medical Services in Europe

2021 ◽  
Author(s):  
Peter Hilbert-Carius ◽  
Manuel F Struck ◽  
Marcus Rudolph ◽  
Jürgen Knapp ◽  
Leif Rognås ◽  
...  
Keyword(s):  
Emergency Medical Services ◽  
Point Of Care ◽  
Expert Committee ◽  
Point Of Care Ultrasound ◽  
Trauma Patients ◽  
Web Portal ◽  
Helicopter Emergency Medical Services ◽  
Medical Directors ◽  
Near Future ◽  
Online Web

Abstract Background: The extent to which Point-of-care of ultrasound (POCUS) is used in different European helicopter EMS (HEMS) is unknown. We aimed to study the availability, perception, and future aspects of POCUS in the European HEMS. Methods: A survey about the use of POCUS in HEMS was conducted by a multinational steering expert committee and was carried out from November 30, 2020 to December 30, 2020 via an online web portal. Invitations for participation were sent via email to the medical directors of the European HEMS organizations including two reminders. Results: During the study period, 69 participants from 25 countries and 41 different HEMS providers took part in the survey. 96% (n=66) completed the survey. POCUS was available in 75% of the responding HEMS organizations when needed (56% always, and 19% occasionally). 17% were planning to establish POCUS in the near future. Responders who provided POCUS used it in approximately 15% of the patients. Participants thought that POCUS is important in both trauma and non-trauma-patients (73%, n=46). The extended focused assessment sonography for trauma (eFAST) protocol (77%) was the most common used protocol. A POCUS credentialing process including documented examinations was requested in less than one third of the HEMS organizations.Conclusions: The majority of the HEMS organizations in Europe are able to provide different POCUS protocols in their services. The most used POCUS protocols were eFAST, FATE and RUSH. Despite the enthusiasm for POCUS, comprehensive training and clear credentialing processes are lacking in about two thirds of the European HEMS organizations.

scholarly journals Point-of-Care Ultrasound (POCUS) Practices in the Helicopter Emergency Medical Services in Europe

2021 ◽  
Author(s):  
Peter Hilbert-Carius ◽  
Manuel F Struck ◽  
Marcus Rudolph ◽  
Jürgen Knapp ◽  
Leif Rognås ◽  
...  
Keyword(s):  
Emergency Medical Services ◽  
Point Of Care ◽  
Expert Committee ◽  
Point Of Care Ultrasound ◽  
Trauma Patients ◽  
Web Portal ◽  
Helicopter Emergency Medical Services ◽  
Medical Directors ◽  
Near Future ◽  
Online Web

Abstract Background: The extent to which Point-of-care of ultrasound (POCUS) is used in different European helicopter EMS (HEMS) is unknown. We aimed to study the availability, perception, and future aspects of POCUS in the European HEMS. Methods: A survey about the use of POCUS in HEMS was conducted by a multinational steering expert committee and was carried out from November 30, 2020 to December 30, 2020 via an online web portal. Invitations for participation were sent via email to the medical directors of the European HEMS organizations including two reminders. Results: During the study period, 69 participants from 25 countries and 41 different HEMS providers took part in the survey. 96% (n=66) completed the survey. POCUS was available in 75% of the responding HEMS organizations when needed (56% always, and 19% occasionally). 17% were planning to establish POCUS in the near future. Responders who provided POCUS used it in approximately 15% of the patients. Participants thought that POCUS is important in both trauma and non-trauma-patients (73%, n=46). The extended focused assessment sonography for trauma (eFAST) protocol (77%) was the most common used protocol. A POCUS credentialing process including documented examinations was requested in less than one third of the HEMS organizations.Conclusions: The majority of the HEMS organizations in Europe are able to provide different POCUS protocols in their services. The most used POCUS protocols were eFAST, FATE and RUSH. Despite the enthusiasm for POCUS, comprehensive training and clear credentialing processes are lacking in about two thirds of the European HEMS organizations.

Impact of a 4-hour Introductory eFAST Training Intervention Among Ultrasound-Naïve U.S. Military Medics

2020 ◽  
Vol 185 (5-6) ◽  
pp. e601-e608
Author(s):  
Jonathan D Monti ◽  
Michael D Perreault
Keyword(s):  
Outcome Measures ◽  
Point Of Care ◽  
Resident Physician ◽  
Secondary Outcome ◽  
Training Intervention ◽  
Point Of Care Ultrasound ◽  
Trauma Patients ◽  
Didactic Training ◽  
Combat Casualty ◽  
The Impact

Abstract Introduction Advances in the portability of ultrasound have allowed it to be increasingly employed at the point of care in austere settings. Battlefield constraints often limit the availability of medical officers throughout the operational environment, leading to increased interest in whether highly portable ultrasound devices can be employed by military medics to enhance their provision of combat casualty care. Data evaluating optimal training for effective medic employment of ultrasound is limited however. This prospective observational cohort study’s primary objective was to assess the impact of a 4-hour introductory training intervention on ultrasound-naïve military medic participants’ knowledge/performance of the eFAST application. Materials and Methods Conventional U.S. Army Medics, all naïve to ultrasound, were recruited from across JBLM. Volunteer participants underwent baseline eFAST knowledge assessment via a 50-question multiple-choice exam. Participants were then randomized to receive either conventional, expert-led classroom didactic training or didactic training via an online, asynchronously available platform. All participants then underwent expert-led, small group hands-on training and practice. Participants’ eFAST performance was then assessed with both live and phantom models, followed by a post-course knowledge exam. Concurrently, emergency medicine (EM) resident physician volunteers, serving as standard criterion for trained personnel, underwent the same OSCE assessments, followed by a written exam to assess their baseline eFAST knowledge. Primary outcome measures included (1) post-course knowledge improvement, (2) eFAST exam technical adequacy, and (3) eFAST exam OSCE score. Secondary outcome measures were time to exam completion and diagnostic accuracy rate for hemoperitoneum and hemopericardium. These outcome measures were then compared across medic cohorts and to those of the EM resident physician cohort. Results A total of 34 medics completed the study. After 4 hours of ultrasound training, overall eFAST knowledge among the 34 medics improved from a baseline mean of 27% on the pretest to 83% post-test. For eFAST exam performance, the medics scored an average of 20.8 out of a maximum of 22 points on the OSCE. There were no statistically significant differences between the medics who received asynchronous learning versus traditional classroom-based learning, and the medics demonstrated comparable performance to previously trained EM resident physicians. Conclusions A 4-hour introductory eFAST training intervention can effectively train conventional military medics to perform the eFAST exam. Online, asynchronously available platforms may effectively mitigate some of the resource requirement burden associated with point-of-care ultrasound training. Future studies evaluating medic eFAST performance on real-world battlefield trauma patients are needed. Skill and knowledge retention must also be assessed for this degradable skill to determine frequency of refresher training when not regularly performed.

scholarly journals The unmet demand for point-of-care ultrasound among general pediatricians: a cross-sectional survey

2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Anelah McGinness ◽  
Margaret Lin-Martore ◽  
Newton Addo ◽  
Ashkon Shaahinfar
Keyword(s):  
Online Survey ◽  
Medical Center ◽  
Point Of Care ◽  
Academic Medical Center ◽  
Perceived Usefulness ◽  
Point Of Care Ultrasound ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Pediatric Residents ◽  
Unmet Demand

Abstract Background Point-of-care ultrasound (POCUS) is a noninvasive bedside tool with many pediatric applications but is not currently a formal part of pediatric training and practice. Formal surveys of general pediatricians regarding POCUS training are lacking. We aimed to quantify the baseline ultrasound experience and training needs of general pediatricians and pediatric residents across different practice settings. Methods In 2020, we sent an online survey to 485 current faculty, residents, and graduates from an urban pediatric academic medical center in Northern California. Pediatric subspecialists were excluded. Survey questions about baseline experience, comfort, and perceived usefulness of 20 common POCUS applications were developed by two POCUS experts using existing literature. Chi-squared analysis was used to compare residents versus attendings and to compare attendings practicing in inpatient versus outpatient versus mixed settings. Results Response rate was 20% (98/485). Compared to attendings (n = 73), residents (n = 25) endorsed more exposure to POCUS in medical school (32% vs 5%, p = 0.003) and residency (12% vs 5%, p = 0.003). Respondents endorsed low comfort with POCUS (mean 1.3 out of 5 on Likert scale). Of 20 procedural and diagnostic applications, respondents identified abscess drainage, bladder catheterization, soft tissue, neck, advanced abdominal, and constipation as most useful. Overall, 50% of pediatricians (and 70% of pediatric residents) responded that there were opportunities to use POCUS multiple times a week or more in their clinical practice. Conclusions There is an unmet demand for POCUS training among general pediatricians and trainees in our study. Although the majority of respondents were not POCUS users, our results could guide future efforts to study the role of POCUS in general pediatrics and develop pediatric curricula.

scholarly journals Orthopaedic residents demonstrate retention of point of care ultrasound knowledge after a brief educational session: a quasi experimental study

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Samuel Larrivée ◽  
Robyn Rodger ◽  
Patricia Larouche ◽  
Jeff Leiter ◽  
Tomislav Jelic ◽  
...  
Keyword(s):  
Test Scores ◽  
Orthopaedic Surgery ◽  
Online Survey ◽  
Point Of Care ◽  
Interdisciplinary Approach ◽  
Comfort Level ◽  
Point Of Care Ultrasound ◽  
Significant Drop ◽  
Written Test

Abstract Background Musculoskeletal point of care ultrasound (MSK POCUS) has many uses for orthopaedic surgeons, but orthopaedic trainees are rarely exposed to this modality. The purpose of this project was to assess the usefulness in clinical education of a newly implemented MSK POCUS course in an orthopaedic surgery program. Methods An MSK POCUS course for orthopaedic surgery residents was developed by an interdisciplinary team. Online videos were created to be viewed by residents prior to a half-day long practical course. An online survey covering the level of training of the resident and their previous use of ultrasound (total hours) was completed by the participants prior to the course. Resident’s knowledge acquisition was measured with written pre-course, same-day post-course and six-month follow-up tests. Residents were also scored on a practical shoulder examination immediately after the course and at six-month follow-up. Changes in test scores between time points were evaluated using Wilcoxon signed-rank tests. Results Ten orthopaedic surgery residents underwent the MSK POCUS curriculum. Pre-course interest in MSK-POCUS was moderate (65%) and prior exposure was low (1.5 h mean total experience). Written test scores improved significantly from 50.7 ± 17.0% before to 84.0 ± 10.7% immediately after the course (p < 0.001) and suffered no significant drop at 6 months (score 75.0 ± 8.7%; p = 0.303). Average post-course practical exam score was 78.8 ± 3.1% and decreased to 66.2 ± 11.3% at 6 months (p = 0.012). Residents significantly improved their subjective comfort level with all aspects of ultrasound use at 6 months (p = 0.007–0.018) but did not significantly increase clinical usage frequency. Conclusion An MSK POCUS curriculum was successfully developed and implemented using an interdisciplinary approach. The course succeeded in improving the residents’ knowledge, skills, and comfort with MSK POCUS. This improvement was maintained at 6 months on the written test but did not result in higher frequency of use by the residents.

scholarly journals Incorporating point-of-care ultrasound into daily intensive care unit rounds: Another source of interruptions?

2018 ◽  
Vol 21 (1) ◽  
pp. 18-21
Author(s):  
O Olusanya ◽  
AVK Wong ◽  
J Kirk-Bayley ◽  
P Parulekar
Keyword(s):  
Intensive Care Unit ◽  
Critical Care ◽  
Intensive Care ◽  
Online Survey ◽  
Point Of Care ◽  
Point Of Care Ultrasound ◽  
Clinical Decisions ◽  
Bedside Ultrasonography ◽  
Ward Rounds ◽  
And Training

Point-of-care ultrasound (POCUS) is the use of bedside ultrasonography by the treating clinician, incorporating those images into direct clinical decisions. While there are a number of different techniques and training pathways in this relatively new modality, there has been little discussion around the logistics of integrating POCUS into the standard critical care “business day” of ward rounds, procedures and meetings. This article explores some of these aspects and presents data from an online survey of POCUS practitioners.

scholarly journals P093: Sound check: quality in point of care ultrasound in rural and regional Saskatchewan through participatory action research

CJEM ◽  
2017 ◽  
Vol 19 (S1) ◽  
pp. S109-S110
Author(s):  
A.I. Moshynskyy ◽  
M. Kapusta ◽  
R. McGonigle ◽  
L. Miller ◽  
J.M. O’Brien ◽  
...  
Keyword(s):  
Action Research ◽  
Focus Groups ◽  
Participatory Action Research ◽  
Acute Care ◽  
Emergency Care ◽  
Online Survey ◽  
Point Of Care ◽  
Rural Setting ◽  
Point Of Care Ultrasound ◽  
Participatory Action

Introduction: In the rural setting, Point-of-Care Ultrasound (POCUS) can dramatically impact rural acute care. In Saskatchewan, many rural clinicians have undertaken POCUS training, but widespread integration into rural emergency care remains elusive. We aimed to explore of the obstacles limiting adoption and their possible solutions to inform the development of a robust and innovative rural POCUS program in Saskatchewan. Methods: We conducted a mixed methods Participatory Action Research (PAR) study using surveys and focus groups. Our rural co-investigators identified 4 key realms relating to rural POCUS use: equipment, access to training, quality assurance (QA), and research. These guided the design of an online survey sent out to rural clinicians throughout Saskatchewan. Results of the survey informed the development of three approaches (centralized, hub-and-spoke, and decentralized) to training, QA, and research which were discussed at focus group sessions held at Saskatchewan’s Emergency Medicine Annual Conference (Regina, SK. 2016). The focus groups were facilitated by the study investigators. Responses were analyzed using a simple thematic analysis to identify relevant themes and subthemes. Results: 34 rural clinicians responded to the online survey. There was general agreement that POCUS is valuable in rural acute care, training is difficult to access and should be standardized, and that QA and research are desired but impractical in the current environment. 11 rural clinicians attended the focus groups. Analysis of focus groups yielded seven distinct themes/needs: infrastructure needs, peer networks, common standards, both local and regional training opportunities, academic support, access to resources, and culture change. Seventeen sub-themes were identified and noted as having either a positive or negative and direct or indirect effect on the above themes. Broadly speaking, participants supported a distributed “spoke-hub” model where training, research and QA occurs within distributed, regional hubs with support from academic sites. Conclusion: The adoption of POCUS for emergency care in rural Saskatchewan faces significant opportunities and obstacles. There is interest on the part of rural clinicians to overcome these challenges to improve patient care.

scholarly journals Are seminal vesicles a potential pitfall during pelvic exploration using point-of-care ultrasound (POCUS)?

2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Antoine Fasseaux ◽  
Philippe Pès ◽  
Françoise Steenebruggen ◽  
Florence Dupriez
Keyword(s):  
Online Survey ◽  
Point Of Care ◽  
Seminal Vesicles ◽  
Free Fluid ◽  
Point Of Care Ultrasound ◽  
Ultrasound Images ◽  
Evaluation Tool ◽  
Potential Pitfall ◽  
Therapeutic Benefits ◽  
Dynamic Ultrasound

Abstract Background Trauma is a major cause of death among the working population. Many countries have now adopted a structured approach to trauma management in which ultrasound is used as a primary evaluation tool. While its use has direct therapeutic benefits, many artifacts and pitfalls are inherent to the technique. Knowledge of the most frequently encountered pitfalls in practice could thus help reduce the risk of error and lead to more accurate trauma assessments. Objective This study evaluates a potential pitfall caused by seminal vesicles during focused assessment with sonography for trauma examinations of the male pelvis performed by an emergency physician with experience in point-of-care ultrasound. Methods We took five static and five dynamic (3-s loops) transverse ultrasound images of the pelvis in five healthy males. The images and videos were then incorporated into an online survey and emailed through the World Interactive Network Focused On Critical UltraSound (WINFOCUS) in France and the Ultrasound and Emergency Medicine (UEM) Organization in Belgium. A questionnaire asked anonymous participants to assess the presence of free fluid in the static and dynamic images and to share information about their training and experience in point-of-care ultrasound. To validate the static and dynamic images, the survey was sent to three external radiologists for independent verification. Results A total of 191 individuals responded fully or partially to the survey, 114 of whom completed it. Among the 114 participants who completed the survey, the misinterpretation rate was 0.55 (95CI 0.51–0.60) for all static and dynamic ultrasound transverse pelvic views. The misinterpretation rate was 0.61 (95CI 0.55–0.66) and 0.50 (95CI 0.45–0.55) for static and dynamic ultrasound transverse pelvic views, respectively. The three external radiologists answered the questionnaire correctly without misinterpreting the survey ultrasound views. Conclusions Seminal vesicles are a potential pitfall when interpreting transverse ultrasound images of the male pelvis in the context of point-of-care ultrasound.

scholarly journals Prehospital Evaluation of Effusion, Pneumothorax, & Standstill (PEEPS): Point-of-care Ultrasound in Emergency Medical Services

2015 ◽  
Vol 16 (4) ◽  
pp. 503-509 ◽  
Author(s):  
Sundeep Bhat ◽  
David Johnson ◽  
Jessica Pierog ◽  
Brita Zaia ◽  
Sarah Williams ◽  
...  
Keyword(s):  
Emergency Medical Services ◽  
Point Of Care ◽  
Medical Services ◽  
Point Of Care Ultrasound ◽  
Emergency Medical

scholarly journals The Unmet Demand for Point-of-Care Ultrasound Among General Pediatricians: A Needs Assessment

2021 ◽  
Author(s):  
Anelah McGinness ◽  
Margaret Lin-Martore ◽  
Newton Addo ◽  
Ashkon Shaahinar
Keyword(s):  
Online Survey ◽  
Medical Center ◽  
Point Of Care ◽  
Academic Medical Center ◽  
Perceived Usefulness ◽  
Point Of Care Ultrasound ◽  
Pediatric Residents ◽  
Unmet Demand ◽  
Chi Squared ◽  
Diagnostic Applications

Abstract Background: Point-of-care ultrasound (POCUS) is a noninvasive bedside tool with many pediatric applications but is not currently a formal part of pediatric training and practice. Formal needs assessments of general pediatricians regarding POCUS training are lacking. We aimed to quantify the baseline ultrasound experience and training needs of general pediatricians and pediatric residents across different practice settings.Methods: In 2020, we sent an online survey to 485 current faculty, residents, and graduates from an urban pediatric academic medical center in Northern California. Pediatric subspecialists were excluded. Survey questions about baseline experience, comfort, and perceived usefulness of 20 common POCUS applications were developed by two POCUS experts using existing literature. Chi-squared analysis was used to compare residents versus attendings and to compare attendings practicing in inpatient versus outpatient versus mixed settings. Results: Response rate was 20% (98/485). Compared to attendings (n=73), residents (n=25) endorsed more exposure to POCUS in medical school (32% vs 5%, p=0.003) and residency (12% vs 5%, p=0.003). Respondents endorsed low comfort with POCUS (mean 1.3 out of 5 on Likert scale). Of 20 procedural and diagnostic applications, respondents identified abscess drainage, bladder catheterization, soft tissue, neck, advanced abdominal, and constipation as most useful. Overall, 50% of pediatricians (and 70% of pediatric residents) responded that there were opportunities to use POCUS multiple times a week or more in their clinical practice. Conclusions: There is an unmet demand for POCUS training among general pediatricians and trainees in our study. Our results could guide design of ultrasound curricula for general pediatricians.

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