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全球儿童外科即时超声(POCUS)使用情况调查。

Global survey on point-of-care ultrasound (pocus) use in child surgery.

机构信息

Nuffield Department of Surgical Sciences, University of Oxford, John Radcliffe Hospital, Room 6607, Level 6, Headington, Oxford, OX3 9DU, UK.

Paediatric Surgery Unit, Muhimbili National Hospital, Dar es Salaam, Tanzania.

出版信息

Pediatr Surg Int. 2024 Sep 5;40(1):249. doi: 10.1007/s00383-024-05797-8.

Abstract

PURPOSE

To undertake a global assessment of existing ultrasound practices, barriers to access, point-of-care ultrasound (POCUS) training pathways, and the perceived clinical utility of POCUS in Child Surgery.

METHODS

An electronic survey was disseminated via the GICS (Global Initiative of Children's Surgery) network. 247 anonymized responses from 48 countries were collated. 71.3% (176/247) worked in child surgery.

RESULTS

Ultrasound was critical to practice with 84% (147/176) of requesting one daily or multiple times per week. Only 10% (17/176) could access emergency ultrasound < 1 h from request. The main barrier was a lack of trained personnel. HIC surgeons were more likely to have ultrasound training (24/29; 82.8%) compared with LMICs (74/147; 50.3%) (p = .001319; CI 95%). Self-perceived POCUS competence was associated with regularity of POCUS use (p < 0.001; CI 95%). Those who already practice POCUS most commonly use it for trauma, intussusception, and ultrasound-guided procedures. Majority (90%; 159/176) of child surgeons would attend formal POCUS training if available.

CONCLUSIONS

Ultrasound is critically important in children's surgery globally, however, many surgeons experience barriers to timely access. There is a strong interest in learning POCUS for relevant pediatric surgical applications. Further research is needed to evaluate the best methods of training, accreditation, and governance.

摘要

目的

对现有的超声实践、获取障碍、即时护理超声(POCUS)培训途径进行全球评估,并评估 POCUS 在小儿外科中的临床应用价值。

方法

通过全球儿童外科学倡议(GICS)网络分发电子调查。共收集到来自 48 个国家的 247 名匿名回复。71.3%(176/247)的回复者从事小儿外科工作。

结果

84%(147/176)的回复者每天或每周多次要求进行超声检查,认为超声检查对其工作至关重要。只有 10%(17/176)能够在请求后 1 小时内获得紧急超声检查。主要障碍是缺乏训练有素的人员。高收入国家的外科医生更有可能接受过超声培训(24/29;82.8%),而中低收入国家的外科医生则较少(74/147;50.3%)(p=0.001319;95%置信区间)。自我感知的 POCUS 能力与 POCUS 使用的规律性相关(p<0.001;95%置信区间)。那些已经进行 POCUS 检查的人最常将其用于创伤、肠套叠和超声引导下的操作。如果有机会,大多数(90%;159/176)小儿外科医生都会参加正式的 POCUS 培训。

结论

超声在全球范围内对小儿外科至关重要,但许多外科医生在获得及时检查方面面临障碍。许多外科医生有兴趣学习 POCUS 用于相关的小儿外科应用。需要进一步研究来评估培训、认证和管理的最佳方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b267/11377359/d95b39595490/383_2024_5797_Fig1_HTML.jpg

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