Stowell Jeffrey R, Kessler Ross, Lewiss Resa E, Barjaktarevic Igor, Bhattarai Bikash, Ayutyanont Napatkamon, Kendall John L
Department of Emergency Medicine, Maricopa Integrated Health System, Phoenix, Arizona.
Department of Emergency Medicine, University of Arizona College of Medicine Phoenix, Phoenix, Arizona.
J Clin Ultrasound. 2018 Mar;46(3):167-177. doi: 10.1002/jcu.22559. Epub 2017 Nov 13.
Management 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.
This study was conducted as an online 18-question survey. Survey questions queried respondent demographics, preferences for POCUS use, and barriers to implementation.
2735 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.
Study 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.
对危重症患者的管理需要快速评估和鉴别。床旁超声（POCUS）可提高诊断准确性并指导复苏。本研究旨在描述不同专业中与危重症护理相关的POCUS的使用情况。
本研究以在线18题调查问卷的形式进行。调查问题询问了受访者的人口统计学信息、POCUS使用偏好以及实施障碍。
2735名接收者收到并查看了该调查问卷，其中416人（15.2%）做出了回应。大多数受访者是肺科和危重症医学（62.5%）以及急诊医学（19.9%）专业人员。受访者通过教育课程（26.5%）、 fellowship（23.9%）、住院医师培训（21.6%）或自主学习（17.2%）获得培训。POCUS在诊断和操作指导中使用普遍。与其他专业相比，急诊医学专业人员更有可能利用POCUS评估未分化的低血压（98.5%，P < 0.001）、容量状态和液体反应性（88.2%，P = 0.005）以及心肺骤停（94.1%，P < 0.001）。有限的培训、能力或资质认证是最常见的障碍，多达39.4%的受访者提到了这一点。
研究受访者在多种临床应用中使用POCUS。然而，在照顾危重症患者的临床医生中，使用情况仍存在差异。克服诸如缺乏正规培训、能力或资质认证等障碍可能会提高其使用率。
