Discipline of Emergency Medicine, Faculty of Medicine Memorial University, Canada.
Toronto Rehabilitation Institute, the University of Toronto, Canada.
Can J Rural Med. 2021 Oct-Dec;26(4):160-168. doi: 10.4103/cjrm.cjrm_61_20.
Point-of-care ultrasound (POCUS) is used for diagnostic and procedural guidance by physicians in Newfoundland and Labrador (NL). POCUS use is largely limited to urban locations and the training is variable amongst physicians. The primary aim of this study was to determine the prevalence of POCUS devices in NL and the secondary aim was to characterise the patterns of POCUS use amongst physicians in NL.
This is a mixed-methods cross-sectional study. We determined the prevalence of POCUS devices from purchase records and the patterns of POCUS use through theme-based interviews. The interviews were transcribed, coded and analysed using standardised qualitative methods.
Ten physicians (3 females, 5 rural) participated in the interviews. The overall prevalence of POCUS devices in NL was 12.5/100,000 population. Participants in urban areas had more access to POCUS training and devices. Participants used POCUS on a daily or weekly basis to rule in or out life-threatening conditions and improve access to specialist care. The benefits of POCUS included expedited investigations, decreased radiation and increased patient satisfaction. The barriers to using POCUS were lack of training, time, devices, image archiving software, difficulty generating and interpreting images and patient body habitus.
This is the first study to our knowledge to report the prevalence of POCUS devices in Canada. Physicians who practise in rural NL have limited access to POCUS devices and have identified barriers to POCUS training. Connecting physicians in rural areas with POCUS experts through a province-wide POCUS network may address these barriers and improve healthcare access.
床边超声（POCUS）在纽芬兰和拉布拉多（NL）被医生用于诊断和程序指导。POCUS 的使用主要局限于城市地区，而且医生之间的培训也各不相同。本研究的主要目的是确定 NL 中 POCUS 设备的普及率，次要目的是描述 NL 医生中 POCUS 使用的模式。
这是一项混合方法的横断面研究。我们从购买记录中确定了 POCUS 设备的普及率，通过基于主题的访谈确定了 POCUS 使用模式。访谈内容被转录、编码和使用标准的定性方法进行分析。
10 名医生（3 名女性，5 名来自农村）参加了访谈。NL 中 POCUS 设备的总体普及率为每 10 万人中有 12.5 台。居住在城市地区的参与者更容易获得 POCUS 培训和设备。参与者每天或每周使用 POCUS 来排除或确认危及生命的情况，并改善获得专科护理的机会。POCUS 的好处包括加快检查、减少辐射和提高患者满意度。使用 POCUS 的障碍包括缺乏培训、时间、设备、图像存档软件、生成和解释图像的困难以及患者的体型。
这是我们所知的第一份报告加拿大 POCUS 设备普及率的研究。在 NL 农村地区执业的医生获得 POCUS 设备的机会有限，并确定了 POCUS 培训的障碍。通过全省范围内的 POCUS 网络将农村地区的医生与 POCUS 专家联系起来，可能会解决这些障碍并改善医疗保健的可及性。
