The Use of Point-of-care Ultrasound in Emergency Medical Centers in Korea: a National Cross-sectional Survey

Introduction: The use of regional anesthesia (RA) by emergency physicians (EPs) is expanding in frequency and range of application as expertise in point-of-care ultrasound (POCUS) grows, but widespread use remains limited. We sought to characterize the use of RA by Canadian EPs, including practices, perspectives and barriers to use in the ED. Methods: A cross-sectional survey of Canadian EPs was administered to members of the Canadian Association of Emergency Physicians (CAEP), consisting of sixteen multiple choice and numerical responses. Responses were summarized descriptively as percentages and as the median and inter quartile range (IQR) for quantitative variables. Results: The survey was completed by 149/1144 staff EPs, with a response rate of 13%. EPs used RA a median of 2 (IQR 0-4) times in the past ten shifts. The most broadly used applications were soft tissue repair (84.5% of EPs, n = 126), fracture pain management (79.2%, n = 118) and orthopedic reduction (72.5%, n = 108). EPs agreed that RA is safe to use in the ED (98.7%) and were interested in using it more frequently (78.5%). Almost all (98.0%) respondents had POCUS available, however less than half (49.0%) felt comfortable using it for RA. EPs indicated that they required more training (76.5%), a departmental protocol (47.0%), and nursing assistance (30.2%) to increase their use. Conclusion: Canadian EPs engage in limited use of RA but express an interest in expanding their use. While equipment is available, additional training, protocols, and increased support from nursing staff are modifiable factors that could facilitate uptake of RA in the ED.

Download Full-text

Prehospital ultrasound use among Canadian aeromedical service providers – A cross-sectional survey

CJEM ◽

10.1017/cem.2019.451 ◽

2019 ◽

Vol 22 (3) ◽

pp. 338-341

Author(s):

Anna Sedlakova ◽

Paul Olszynski ◽

Philip Davis ◽

John Froh

Keyword(s):

British Columbia ◽

Prince Edward Island ◽

Service Providers ◽

Point Of Care ◽

Yukon Territory ◽

Free Fluid ◽

Point Of Care Ultrasound ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Patient Disposition

ABSTRACTObjectivesEvidence suggests that prehospital point of care ultrasound (POCUS) may change patient management. It serves as an aid in triage, physical examination, diagnosis, and patient disposition. The rate of adoption of POCUS among aeromedical services throughout Canada is unknown. The objective of this study was to describe current POCUS use among Canadian aeromedical services providers.MethodsThis is a cross-sectional observational study. A survey was emailed to directors of government-funded aeromedical services bases in Canada. Data were analyzed using descriptive statistics.ResultsThe response rate was 82.3% (14/17 aeromedical services directors), representing 41 of 46 individual bases. POCUS is used by aeromedical services in British Columbia, Alberta, Saskatchewan, and Manitoba. New Brunswick, Nova Scotia, Prince Edward Island, and Yukon reported they are planning to introduce POCUS within the next year. Ontario and Newfoundland reported they are not using POCUS and are not planning to introduce it. British Columbia is the only province currently using POCUS on fixed-wing aircraft. Most commonly reported frequency of POCUS use on missions was <25%. Most useful applications are assessment for pneumothorax, abdominal free fluid, and cardiac standstill. The most common barrier to POCUS use is cost of training and maintenance of competence.ConclusionsPrehospital POCUS is available in Western Canada with one third of the Canadian population having access to aeromedical services using ultrasound. The Maritimes and the Yukon Territory will further extend POCUS use on fixed-wing aircraft. While there are barriers to POCUS use, those bases that have adopted POCUS consider it valuable.

Download Full-text

A majority of rural emergency departments in the province of Quebec use point-of-care ultrasound: a cross-sectional survey

BMC Emergency Medicine ◽

10.1186/s12873-015-0063-0 ◽

2015 ◽

Vol 15 (1) ◽

Cited By ~ 10

Author(s):

Pierre Léger ◽

Richard Fleet ◽

Julie Maltais- Giguère ◽

Jeff Plant ◽

Éric Piette ◽

...

Keyword(s):

Emergency Departments ◽

Point Of Care ◽

Point Of Care Ultrasound ◽

Cross Sectional Survey ◽

Cross Sectional

Download Full-text

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

BMC Medical Education ◽

10.1186/s12909-021-03072-1 ◽

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.

Download Full-text

MP003: AP or IP? Introduction of a new assessment of performance tool for point of care ultrasound

CJEM ◽

10.1017/cem.2016.144 ◽

2016 ◽

Vol 18 (S1) ◽

pp. S67-S67

Author(s):

P.R. Atkinson ◽

D. Lewis ◽

J. Fraser

Keyword(s):

Emergency Medicine ◽

Point Of Care ◽

Position Statement ◽

Point Of Care Ultrasound ◽

Entire Body ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Assessment Of Performance ◽

Canadian Association ◽

Assessment Of Practice

Introduction: Organizations including CAEP, CEUS, the International Federation for Emergency Medicine (IFEM) and the Canadian Association of Radiologists have all called for defined competency assessments for point of care ultrasound (PoCUS). Definitions of core indications vary. The requirement for ongoing assessment of performance and skills maintenance is often overlooked. We describe the introduction an IFEM approved Assessment of Practice (AP) tool across a PoCUS training program and for continued assessment. Methods: We completed a cross sectional survey and cohort study including the entire body of emergency medicine physicians at a tertiary hospital. Over a 3 year period, all practitioners were assessed for CAEP position statement defined core applications at baseline and again after 2 years using a published PoCUS AP tool. We describe the tool, its application and the performance assessment findings. Emergency physicians (EP) underwent AP following formal training including an approved course and a logbook documenting a variable number of scans. Results: 23 EPs completed training and underwent AP initially, with all 23 EPs completing further assessment within 3 years. Assessment of practice was completed for 1. Focused Diagnostic Ultrasound Assessment for AAA, eFAST, cardiac, early pregnancy; and 2. Focused Procedural Ultrasound Guidance for venous catheterization. All EPs demonstrated initial and continuing competency in these PoCUS modalities. Conclusion: The IFEM PoCUS curriculum promotes ongoing local assessment of performance. We successfully implemented this competency based approach and demonstrated feasibility, flexibility and utility in a Canadian emergency medicine program.

Download Full-text

Point-of-care-ultrasound (POCUS) in Canadian hospitals during the COVID-19 pandemic: a cross-sectional survey

Canadian Journal of Anesthesia/Journal canadien d anesthésie ◽

10.1007/s12630-021-02093-0 ◽

2021 ◽

Author(s):

Marcie Beaulac ◽

Michelle Clunie ◽

Paul Olszynski ◽

Jennifer O’Brien

Keyword(s):

Point Of Care ◽

Point Of Care Ultrasound ◽

Cross Sectional Survey ◽

Cross Sectional

Download Full-text

National Survey of Point-of-Care Ultrasound Scholarly Tracks in Emergency Medicine Residency Programs

Western Journal of Emergency Medicine ◽

10.5811/westjem.2021.5.52118 ◽

2021 ◽

Vol 22 (5) ◽

pp. 1095-1101

Author(s):

Stephen Alerhand ◽

Elaine Situ-Lacasse ◽

Christine Ramdin ◽

Michael Gottlieb

Keyword(s):

Emergency Medicine ◽

Point Of Care ◽

Survey Study ◽

Point Of Care Ultrasound ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Residency Programs ◽

The Past ◽

Current Prevalence ◽

Hands On

Introduction: Residency scholarly tracks are educational programs, designed to help trainees develop an area of expertise. Although the breadth of residency point-of-care ultrasound (POCUS) education has developed considerably in recent years, there is no literature to date describing scholarly tracks specifically in POCUS. In this study we sought to determine the prevalence, characteristics, and outcomes of POCUS scholarly tracks in emergency medicine (EM). Methods: This was a cross-sectional survey of EM residency programs accredited by the Accreditation Council for Graduate Medical Education. Surveys were distributed between March-August 2020 using a listserv followed by targeted emails to residency and ultrasound leadership. We summarized data using descriptive statistics, and performed logistic regression to identify factors associated with a POCUS scholarly track. Results: Of 267 residency programs 199 (74.5%) completed the survey. Fifty-seven (28.6%) had a POCUS scholarly track as of the 2019-2020 academic year. Scholarly tracks in POCUS were more common in university-based/academic sites and larger residency programs. Of the 57 programs with POCUS scholarly tracks, 48 (84.2%) required residents to present at least one POCUS lecture, 45 (78.9%) required residents to serve as instructor at a hands-on workshop, and 42 (73.7%) required residents to participate in quality assurance of departmental POCUS scans. Only 28 (49.1%) tracks had a structured curriculum, and 26 (45.6%) required POCUS research. In total, 300 EM residents completed a POCUS scholarly track over the past three academic years, with a median of 4 (2-9) per program. Seventy-five (25.0%) proceeded to a clinical ultrasound fellowship after residency graduation, with a median of 1 (interquartile range 0-2) per program. A total of 139 POCUS-specific abstracts (median 2 [0-3]) and 80 peer-reviewed manuscripts (median 1 [0-2]) were published by scholarly track residents over the past three years. Conclusion: This survey study describes the current prevalence, characteristics, and outcomes of POCUS scholarly tracks across EM residency programs. The results may inform the decisions of residency programs to create these tracks.

Download Full-text

P121: Prehospital ultrasound use among Canadian aeromedical service providers – a cross-sectional survey

CJEM ◽

10.1017/cem.2019.312 ◽

2019 ◽

Vol 21 (S1) ◽

pp. S107-S108

Author(s):

A. Sedlakova ◽

J. Froh ◽

P. Olszynski ◽

P. Davis

Keyword(s):

Prince Edward Island ◽

Service Providers ◽

Point Of Care ◽

Yukon Territory ◽

Point Of Care Ultrasound ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Patient Disposition ◽

Canadian Population ◽

Canada Data

Introduction: Evidence suggests that prehospital point of care ultrasound (POCUS) may improve outcomes. It serves as an aid in physical examination, triage, diagnosis, and patient disposition. The rate of adoption of POCUS among aeromedical services (AMS) throughout Canada is unknown. The objective of this study was to describe current POCUS use among Canadian AMS providers. Methods: This is a cross-sectional observational study. A survey was emailed to directors of government-funded AMS bases in Canada. Data was analyzed using descriptive statistics. Results: The response rate was 88.2% (15/17 AMS directors) and accounted for 42 out of 46 individual bases. POCUS is used by AMS in British Columbia, Alberta, Saskatchewan, and Manitoba. New Brunswick, Nova Scotia, Prince Edward Island, and Yukon are planning to introduce POCUS within the next year. Ontario, Quebec, and Newfoundland are not utilizing POCUS and are not planning to introduce it. BC is the only province currently using POCUS on fixed-wing aircraft. POCUS is used in <25% of missions, most frequently at sending hospital and in flight. Most useful applications were assessment for pneumothorax, free abdominal fluid, and cardiac standstill. Most common barrier to POCUS use was cost of training and maintenance of competence. Conclusion: Prehospital POCUS is available in Western Canada with one third of the Canadian population having access to AMS utilizing ultrasound. The Maritimes and the Yukon Territory will further extend POCUS use on fixed-wing aircraft. While there are barriers to POCUS use, those bases that have adopted POCUS consider it valuable.

Download Full-text

Use of Handheld Versus Standard Ultrasound Devices in Ultrasound Rotation at the Emergency Department

Open Access Macedonian Journal of Medical Sciences ◽

10.3889/oamjms.2021.5528 ◽

2021 ◽

Vol 9 (E) ◽

pp. 29-32

Author(s):

Kamonwon Ienghong ◽

Kotchakorn Jumroenketpratheep ◽

Somsak Tiamkao ◽

Korakot Apiratwarakul

Keyword(s):

Emergency Department ◽

Emergency Medicine ◽

Point Of Care ◽

Learning Experience ◽

Baseline Survey ◽

Point Of Care Ultrasound ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Handheld Device ◽

Handheld Ultrasound

BACKGROUND: Recently, handheld ultrasound equipment has come to replace standard machines in the training of emergency medicine residents. However, there have been few studies examining how this change has affected medical education. AIM: We aimed to compare standard and handheld ultrasound machines as educational tools in the emergency medicine residency program. METHODS: A cross-sectional survey of 17 emergency medicine residents at Srinagarind Hospital emergency department were trained to use point-of-care ultrasound and provided with handheld ultrasound devices during their 2-week ultrasound rotations, which took place between July 2019 and May 2020. Participants were given a 25-question survey comparing their learning experiences with standard versus handheld ultrasound machines. Data were analyzed using an independent sample t-test, and p < 0.05 was considered statistically significant. RESULTS: The response rate was 100%. At the baseline survey, most participants rated their learning experience as greater than 4 out of 5 with both ultrasound devices. They rated the learning experience with the handheld device as being more enjoyable and accessible but not to a statistically significant extent. There were also no significant differences in participants’ ratings of image quality or the ease of obtaining images. However, they rated the handheld device as being more useful and convenient (p < 0.001 and 0.034, respectively). CONCLUSIONS: The handheld ultrasound machine is useful in the training of emergency medicine residents. Further studies should be conducted to evaluate residents’ competency in using these devices.

Download Full-text