Nixon Garry, Blattner Kati, Muirhead Jillian, Finnie Wendy, Lawrenson Ross, Kerse Ngaire
Dunedin School of Medicine, University of Otago, Dunedin, New Zealand.
Medical Research Centre, University of Waikato and Waikato District Health Board, New Zealand.
J Prim Health Care. 2018 Oct;10(3):224-236. doi: 10.1071/HC18031.
INTRODUCTION Point-of-care ultrasound (POCUS) is an increasingly common adjunct to the clinical assessment of patients in rural New Zealand. AIM To describe the scope of POCUS being practiced by rural generalist hospital doctors and gain insights, from their perspective, into its effect. METHODS This was a mixed-methods descriptive study. Main outcome measures were type and frequency of POCUS being undertaken. A questionnaire was given to POCUS-active rural hospital doctors to survey the effect of POCUS on clinical practice and assess issues of quality assurance. RESULTS The most commonly performed scans were: cardiac (18%) and volume scans (inferior vena cava and jugular venous pressure) (14%), followed by gallbladder (13%), kidney (11%), Focused Assessment with Sonography in Trauma (FAST) (7%), bladder (6%), leg veins (6%) and lungs (5%). There was large variation in frequency of scan types between the study hospitals that could not be accounted for by differences in training. DISCUSSION Rural generalists consider the broad scope of POCUS they practise to be an important but challenging skill set. Clinical governance, including an agreed scope and standards, may increase the benefits and improve the safety of rural POCUS.
即时超声检查（POCUS）在新西兰农村地区作为对患者临床评估的辅助手段正变得越来越普遍。目的：描述农村全科医院医生开展即时超声检查的范围，并从他们的角度深入了解其效果。方法：这是一项混合方法的描述性研究。主要观察指标是进行即时超声检查的类型和频率。向积极开展即时超声检查的农村医院医生发放问卷，以调查即时超声检查对临床实践的影响并评估质量保证问题。结果：最常进行的扫描是：心脏（18%）和容量扫描（下腔静脉和颈静脉压）（14%），其次是胆囊（13%）、肾脏（11%）、创伤超声重点评估（FAST）（7%）、膀胱（6%）、腿部静脉（6%）和肺部（5%）。各研究医院之间扫描类型的频率存在很大差异，无法用培训差异来解释。讨论：农村全科医生认为他们所开展的即时超声检查范围广泛，是一项重要但具有挑战性的技能组合。临床治理，包括商定的范围和标准，可能会增加农村即时超声检查的益处并提高其安全性。
