Critical care ultrasound: A national survey across specialties

被引:25
作者
Stowell, Jeffrey R. [1 ,2 ]
Kessler, Ross [3 ]
Lewiss, Resa E. [4 ]
Barjaktarevic, Igor [5 ]
Bhattarai, Bikash [6 ,7 ]
Ayutyanont, Napatkamon [6 ,7 ]
Kendall, John L. [8 ]
机构
[1] Maricopa Integrated Hlth Syst, Dept Emergency Med, Phoenix, AZ USA
[2] Univ Arizona, Coll Med Phoenix, Dept Emergency Med, Phoenix, AZ USA
[3] Univ Michigan, Dept Emergency Med, Ann Arbor, MI 48109 USA
[4] Thomas Jefferson Univ, Dept Emergency Med, Philadelphia, PA 19107 USA
[5] Univ Calif Los Angeles, David Geffen Sch Med, Div Pulm & Crit Care Med, Los Angeles, CA 90095 USA
[6] Maricopa Integrated Hlth Syst, Dept Grants & Res, Phoenix, AZ USA
[7] Univ Arizona, Dept Med Adm, Coll Med Phoenix, Phoenix, AZ USA
[8] Denver Hlth Med Ctr, Dept Emergency Med, Denver, CO USA
关键词
critical care; education; emergency medicine; ultrasound; CARDIAC ULTRASONOGRAPHY; FLUID RESPONSIVENESS; EMERGENCY PHYSICIANS; APPROPRIATE USE; TIME; SHOCK; SONOGRAPHY; GUIDELINES; EVOLUTION; DIAGNOSIS;
D O I
10.1002/jcu.22559
中图分类号
O42 [声学];
学科分类号
070206 ; 082403 ;
摘要
PurposeManagement of the critically ill patient requires rapid assessment and differentiation. Point-of-care ultrasound (POCUS) improves diagnostic accuracy and guides resuscitation. This study sought to describe the use of critical care related POCUS amongst different specialties. MethodsThis study was conducted as an online 18-question survey. Survey questions queried respondent demographics, preferences for POCUS use, and barriers to implementation. Results2735 recipients received and viewed the survey with 416 (15.2%) responses. The majority of respondents were pulmonary and critical care medicine (62.5%) and emergency medicine (19.9%) providers. Respondents obtained training through educational courses (26.5%), fellowship (23.9%), residency (21.6%), or self-guided learning (17.2%). POCUS use was common for diagnostic and procedural guidance. Emergency medicine providers were more likely to utilize POCUS to evaluate undifferentiated hypotension (98.5%, P<.001), volume status and fluid responsiveness (88.2%, P=.005), and cardiopulmonary arrest (94.1%, P<.001) compared to other specialties. Limited training, competency, or credentialing were the most common barriers, in up to 39.4% of respondents. ConclusionStudy respondents utilize POCUS in a variety of clinical applications. However, a disparity in utilization still exists among clinicians who care for critically ill patients. Overcoming barriers, such as a lack of formalized training, competency, or credentialing, may lead to increased utilization.
引用
收藏
页码:167 / 177
页数:11
相关论文
共 32 条
[1]  
American College of Emergency Physicians, 2009, Ann Emerg Med, V53, P550, DOI 10.1016/j.annemergmed.2008.12.013
[2]  
American Medical Association, POL SUNS REP 2000 AM
[3]   Abdominal and Cardiac Evaluation with Sonography in Shock (ACES): an approach by emergency physicians for the use of ultrasound in patients with undifferentiated hypotension [J].
Atkinson, P. R. T. ;
McAuley, D. J. ;
Kendall, R. J. ;
Abeyakoon, O. ;
Reid, C. G. ;
Connolly, J. ;
Lewis, D. .
EMERGENCY MEDICINE JOURNAL, 2009, 26 (02) :87-91
[4]   A prospective comparison of supine chest radiography and bedside ultrasound for the diagnosis of traumatic pneumothorax [J].
Blaivas, M ;
Lyon, M ;
Duggal, S .
ACADEMIC EMERGENCY MEDICINE, 2005, 12 (09) :844-849
[5]   Outcome in cardiac arrest patients found to have cardiac standstill on the bedside emergency department echocardiogram [J].
Blaivas, M ;
Fox, JC .
ACADEMIC EMERGENCY MEDICINE, 2001, 8 (06) :616-621
[6]   Do emergency physicians save time when locating a live intrauterine pregnancy with bedside ultrasonography? [J].
Blaivas, M ;
Sierzenski, P ;
Plecque, D ;
Lambert, M .
ACADEMIC EMERGENCY MEDICINE, 2000, 7 (09) :988-993
[7]   Rapid Ultrasound in Shock (RUSH) Velocity-Time Integral A Proposal to Expand the RUSH Protocol [J].
Blanco, Pablo ;
Aguiar, Francisco Miralles ;
Blaivas, Michael .
JOURNAL OF ULTRASOUND IN MEDICINE, 2015, 34 (09) :1691-1700
[8]   Fluid resuscitation in septic shock: A positive fluid balance and elevated central venous pressure are associated with increased mortality [J].
Boyd, John H. ;
Forbes, Jason ;
Nakada, Taka-aki ;
Walley, Keith R. ;
Russell, James A. .
CRITICAL CARE MEDICINE, 2011, 39 (02) :259-265
[9]   Comparison of quality and cost-effectiveness in the evaluation of symptomatic cholelithiasis with different approaches to ultrasound availability in the ED [J].
Durston, W ;
Carl, ML ;
Guerra, W ;
Eaton, A ;
Ackerson, L ;
Rieland, T ;
Schauer, B ;
Chisum, E ;
Harrison, MT ;
Navarro, ML .
AMERICAN JOURNAL OF EMERGENCY MEDICINE, 2001, 19 (04) :260-269
[10]   Barriers to ultrasound training in critical care medicine fellowships: A survey of program directors [J].
Eisen, Lewis A. ;
Leung, Sharon ;
Gallagher, Annemarie E. ;
Kvetan, Vladimir .
CRITICAL CARE MEDICINE, 2010, 38 (10) :1978-1983