Naeem Salman, Edmunds Christopher, Hirst Thomas, Williams Julia, Alzarrad Amir, Ronaldson James, Barrat Jon
Barts Health NHS trust London United Kingdom.
East Anglian Air Ambulance Norwich United Kingdom.
POCUS J. 2022 Nov 21;7(2):232-238. doi: 10.24908/pocus.v7i2.15739. eCollection 2022.
Point of care ultrasound (POCUS) has become a common practice in prehospital care over the last 10 years. There is lack of literature on its use and governance structure in United Kingdom (UK) prehospital care services. We aimed to survey the use, governance of prehospital POCUS among UK prehospital services and perceptions of clinicians and services regarding its utility and barriers to its implementation. Four electronic questionnaire surveys were delivered to UK helicopter emergency medical service (HEMS) & clinicians, ambulance and community emergency medicine (CEM) services between 1 of April and 31 of July 2021 investigating current use, governance structure for POCUS and perception about its benefits and barriers. Invitations were sent via email to medical directors or research leads of services and using social media. Survey links remained live for two months each. Overall, 90%, 62% and 60% of UK HEMS, ambulance and CEM services respectively, responded to surveys. Most of the services used prehospital POCUS, however only two HEMS organisations fulfilled the Royal College of Radiology governance criteria for POCUS. The most commonly performed POCUS modality was echo in cardiac arrest. Majority of clinicians judged POCUS to be beneficial and the common perceived benefit was promotion of enhanced and effective clinical care. Major barriers to its implementation included a lack of formal governance, limited literature supporting its use and difficulties in performing POCUS in prehospital environment. This survey demonstrates that prehospital POCUS is being provided by a majority of the prehospital care services and clinicians have found it beneficial in providing enhanced clinical care to their patients. However, the barriers to its implementation are relative lack of governance structure and supportive literature.
在过去十年中，床旁超声（POCUS）已成为院前急救中的一种常见做法。关于其在英国院前急救服务中的使用和管理结构，缺乏相关文献。我们旨在调查英国院前急救服务中院前POCUS的使用、管理情况，以及临床医生和服务机构对其效用和实施障碍的看法。2021年4月1日至7月31日期间，向英国直升机紧急医疗服务（HEMS）、临床医生、救护车和社区急诊医学（CEM）服务机构进行了四项电子问卷调查，调查当前POCUS的使用情况、管理结构以及对其益处和障碍的看法。通过电子邮件向各服务机构的医疗主任或研究负责人发送邀请，并利用社交媒体进行宣传。每个调查链接持续开放两个月。总体而言，英国HEMS、救护车和CEM服务机构分别有90%、62%和60%的机构回复了调查。大多数服务机构使用院前POCUS，但只有两个HEMS组织符合皇家放射学院对POCUS的管理标准。最常进行的POCUS检查方式是心脏骤停时的超声心动图检查。大多数临床医生认为POCUS有益，普遍认为的益处是促进了更优质、有效的临床护理。其实施的主要障碍包括缺乏正式管理、支持其使用的文献有限以及在院前环境中进行POCUS检查存在困难。这项调查表明，大多数院前急救服务机构都在提供院前POCUS，临床医生发现它有助于为患者提供更好的临床护理。然而，其实施的障碍是相对缺乏管理结构和支持性文献。
