Department of Anesthesiology, Loma Linda University Medical Center, Loma Linda, California, USA.
Department of Emergency Medicine, Loma Linda University Medical Center, Loma Linda, California, USA.
Postgrad Med J. 2022 Sep 1;98(1163):694-699. doi: 10.1136/postgradmedj-2021-140127.
Point-of-care ultrasound (POCUS) is ultrasound brought to the patient's bedside and performed in 'real time' by the healthcare provider. The utility of POCUS to facilitate management of the acutely ill patient has been demonstrated for multiple pathologies. However, the integration of ultrasonography and echocardiography training into residency curriculum varies across the acute care specialties.
After an institutional review board approval, anaesthesiology, emergency medicine, family medicine, internal medicine, paediatrics and general surgery programme directors (PDs) were surveyed. The survey consisted of 11 questions evaluating the primary bedside assessment tool for common acute care situations, POCUS topics that the PDs were comfortable practising and topics that the PDs felt were useful for their specialty. Barriers to POCUS use, certification and documentation were also surveyed.
Overall, 270 PD surveys were completed. The preferred primary assessment tool for common acute care situations varied with specialty; emergency medicine PDs consistently responded that POCUS was the diagnostic modality of choice (p<0.0001). The majority of the PDs reported lack of educational opportunities as the primary barrier to learning POCUS (64%). Most PDs indicated that POCUS examinations should be documented (95.7%), and 39% reported that departmental certification would be sufficient.
This study is the first to evaluate differences in the preferred initial bedside assessment tool between the acute care specialties. Although POCUS is a superior tool for evaluating acute pathologies, disconnect between education and utilisation remains. This study highlights the need to incorporate POCUS into the acute care specialty curriculum.
床边即时超声检查（POCUS）是将超声带到患者床边，并由医疗保健提供者实时进行的检查。POCUS 在多种疾病的管理中都有助于改善患者的预后，其作用已得到证实。然而，超声心动图和超声检查培训在急症医学专业课程中的整合在各个专业之间存在差异。
在获得机构审查委员会的批准后，对麻醉科、急诊医学科、家庭医学科、内科、儿科和普通外科项目主任（PD）进行了调查。该调查共包含 11 个问题，评估了常见急症情况下的主要床边评估工具、PD 能够熟练操作的 POCUS 相关课题以及 PD 认为对其专业有用的课题。还对 POCUS 使用、认证和记录的障碍进行了调查。
总共完成了 270 份 PD 调查。在常见急症情况下，首选的主要评估工具因专业而异；急诊医学科 PD 始终认为 POCUS 是首选的诊断方法（p<0.0001）。大多数 PD 报告缺乏教育机会是学习 POCUS 的主要障碍（64%）。大多数 PD 表示应记录 POCUS 检查（95.7%），39%的 PD 报告部门认证就足够了。
这项研究首次评估了急症医学专业之间首选初始床边评估工具的差异。尽管 POCUS 是评估急性疾病的优越工具，但教育与应用之间仍然存在脱节。这项研究强调了将 POCUS 纳入急症医学专业课程的必要性。
