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土耳其的一项描述性研究:儿科急诊部和重症监护病房中即时超声的应用。

The Use of Point-of-Care Ultrasound in Pediatric Emergency Departments and Intensive Care Units: A Descriptive Study From Turkey.

机构信息

From the Pediatric Emergency Department, Balikesir Ataturk City Hospital, Balikesir, Turkey.

Pediatric Intensive Care Unit, Dokuz Eylul University Faculty of Medicine, Izmir, Turkey.

出版信息

Pediatr Emerg Care. 2024 Nov 1;40(11):796-800. doi: 10.1097/PEC.0000000000003252. Epub 2024 Aug 23.

Abstract

OBJECTIVES

The aim was to evaluate the current status of point-of-care ultrasound (POCUS), perceptions, education, training, and barriers to using POCUS in pediatric emergency departments (PEDs) and pediatric intensive care units (PICUs) in Turkey.

METHODS

A descriptive, multicenter, cross-sectional study through an online survey was developed using the REDCap online platform. The survey was distributed through the Turkish Society of Pediatric Emergency and Intensive Care e-mail group. Each survey was answered only once by each PED/PICU and by the clinical chief of the department.

RESULTS

A total of 19 PEDs and 26 PICUs responded to the survey. Among them, 84.2% of PEDs and 100% of PICUs reported the clinical use of POCUS. For diagnostic applications, the most common areas for PEDs and PICUs were thoracic (93.7%/100%) and cardiovascular (62.5%/65.4%) assessment, and in the procedural use of POCUS, the most frequent applications were those for vascular access (75.0%/92.3%) and thoracentesis (31.2%/65.4%). The most commonly reported clinical benefits were rapid diagnosis, rapid treatment, and decreased complications during procedural applications for PEDs and PICUs. Evaluating the barriers to POCUS use in PEDs and PICUs, the most common reasons for insufficient use were the lack of ultrasound machines and/or equipment, a shortage of manpower, lack of awareness, and lack of training. For PEDs (68.4%) and for PICUs (84.6%), participants agreed that POCUS training should be mandatory during fellowship programs.

CONCLUSIONS

Most participants were aware of the need for POCUS. However, lack of education, equipment, manpower, and infrastructure still emerged as barriers to the use of POCUS. To further promote POCUS use, it would be helpful to improve accessibility by ensuring sufficient numbers of ultrasound devices together with sufficient numbers of appointed physicians and by expanding POCUS education in PEDs and PICUs.

摘要

目的

本研究旨在评估土耳其儿科急诊部(PED)和儿科重症监护病房(PICU)中即时超声(POCUS)的使用现状、认知、教育、培训和障碍。

方法

采用在线 REDCap 平台开发描述性、多中心、横断面研究。该调查通过土耳其儿科学急救和重症监护电子通讯组进行分发。每个 PED/PICU 和科室临床主任仅对调查进行一次回答。

结果

共有 19 个 PED 和 26 个 PICU 对调查做出回应。其中,84.2%的 PED 和 100%的 PICU 报告了 POCUS 的临床应用。在诊断应用方面,最常见的 PED 和 PICU 部位是胸部(93.7%/100%)和心血管(62.5%/65.4%)评估,而在 POCUS 的程序性应用中,最常见的应用是血管通路(75.0%/92.3%)和胸腔穿刺术(31.2%/65.4%)。最常报告的临床益处是快速诊断、快速治疗以及减少 PED 和 PICU 程序性应用中的并发症。在评估 PED 和 PICU 中 POCUS 使用的障碍时,使用率不足的最常见原因是缺乏超声机和/或设备、人力短缺、缺乏意识和缺乏培训。对于 PED(68.4%)和 PICU(84.6%),参与者均认为 POCUS 培训应在专科医师培训项目中成为强制性要求。

结论

大多数参与者意识到了 POCUS 的必要性。然而,教育、设备、人力和基础设施的缺乏仍然是 POCUS 使用的障碍。为了进一步促进 POCUS 的使用,通过确保足够数量的超声设备和指定的医师数量并扩大 PED 和 PICU 中的 POCUS 教育,可以帮助提高其可及性。

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