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Prevalence and utility of point‐of‐care ultrasound in the emergency department: A prospective observational study
Author(s) -
Pouryahya Pourya,
McR Meyer Alastair D.,
Koo Mei Ping Melody
Publication year - 2019
Publication title -
australasian journal of ultrasound in medicine
Language(s) - English
Resource type - Journals
eISSN - 2205-0140
pISSN - 1836-6864
DOI - 10.1002/ajum.12172
Subject(s) - medicine , observational study , point of care ultrasound , emergency department , emergency medicine , prospective cohort study , chest pain , surgery , nursing
Objective An observational study on the current diagnostic and procedural utility, as well as impact of point‐of‐care ultrasound (POCUS) in the emergency department (ED). Background Point‐of‐care ultrasound (POCUS) has been recognised as a useful non‐invasive bedside tool in providing valuable information, as well as its utility in procedural guidance for clinicians. However, its current prevalence and utility in ED remain unknown. Methods In October 2016, a 31‐day prospective observational study was performed in three Monash Health Emergency Departments in Melbourne, Australia. Data regarding patients’ presenting complaints, frequency, operators’ qualifications and POCUS module were collected and analysed. Factors associated with diagnostic impacts were identified. Results A total of 390 (2.1%) POCUS examinations were performed among 18,355 presentations in the three Monash Health EDs during the study period. POCUS was performed as a diagnostic tool in 344 (88.2%) and procedural guidance in 46 (11.8%) cases. eFAST/AAA and bedside echocardiography were the two most frequently utilised diagnostic modules. Overall, the majority of diagnostic POCUS cases were indicated for abdominal pain (35.3%), chest pain (14.0%) and trauma mainly traffic accidents (5.8%). Procedural POCUS was most commonly used for vascular access (71.7%), where dyspnoea (21.6%) was the most common presenting complaint. The majority of the cases were performed by FACEMs (Fellows of Australasian College of Emergency Medicine) (66.4%). Conclusions Despite known diagnostic and procedural values, the prevalence of POCUS in ED was found to be lower than what was expected. The prevalence was shown to be proportional to the level of clinical expertise among the operators. Training and utility of POCUS among physicians and trainees should be further advocated and supported.