Parasram Melvin, Loiseau Shamelia Y, Subramaniam Thanujaa, Dangayach Neha S, Sarwal Aarti, Ch'ang Judy H
Department of Neurology, Weill Cornell Medicine, New York, 520 East 70th Street Starr Pavilion, 607, NY, USA.
Department of Neurology, The Warren Alpert Medical School of Brown University, Providence, RI, USA.
Neurocrit Care. 2024 Dec 17. doi: 10.1007/s12028-024-02174-0.
Point-of-care ultrasound (POCUS)/critical care ultrasound (CCU) use in medical and surgical intensive care units has surged over the last few decades. It is unclear if this has similarly translated in neurocritical care (NCC) units. We designed a survey to describe the current state of POCUS/CCU use and training among NCC providers.
An online 13-question survey was distributed nationally through newsletters and social media after endorsement by the Neurocritical Care Society. Participation was voluntary, and responses were anonymous. The survey queried respondent demographics, training, clinical use, confidence in POCUS/CCU, and barriers to POCUS/CCU use.
Overall, 119 NCC providers responded to the survey. Most respondents were attending neurointensivists (52.1%) and had completed neurology residency training (62.2%). Approximately 23% of respondents did not have training in POCUS/CCU, and 71% of respondents had not completed POCUS/CCU board-certified training. Fifty-five percent of respondents used POCUS/CCU in their practice frequently, and 37% used it rarely on a weekly basis. Thirty-six percent and 42% of respondents felt moderately skilled at acquiring and interpreting POCUS/CCU images, respectively. Ultrasound guidance for procedures was the most common technique used by respondents. Most respondents felt that using ultrasound for volume status, procedural guidance, and evaluation of shock influenced clinical decision-making. Lack of confidence in interpreting data/imaging and comfort in performing POCUS/CCU were the most common barriers to ultrasound use. Respondents agreed with incorporation of POCUS/CCU training in NCC fellowship milestones and creating resources for credentialing providers in POCUS/CCU to increase use of POCUS/CCU in NCC.
This national survey indicated that POCUS/CCU is moderately used among NCC providers. However, more formalized and robust training in POCUS/CCU is needed for trainees and practitioners in NCC to enhance comfortability with using ultrasound for clinical assessments.
在过去几十年中，医学和外科重症监护病房中即时超声检查（POCUS）/重症监护超声检查（CCU）的应用激增。目前尚不清楚这在神经重症监护（NCC）病房中是否有类似的情况。我们设计了一项调查，以描述NCC医护人员中POCUS/CCU的使用现状和培训情况。
在获得神经重症监护学会认可后，通过时事通讯和社交媒体在全国范围内开展了一项包含13个问题的在线调查。参与是自愿的，回答是匿名的。该调查询问了受访者的人口统计学特征、培训情况、临床使用情况、对POCUS/CCU的信心以及POCUS/CCU使用的障碍。
总体而言，119名NCC医护人员回复了调查。大多数受访者是神经重症监护专科医生（52.1%），并且已经完成了神经科住院医师培训（62.2%）。约23%的受访者没有接受过POCUS/CCU培训，71%的受访者未完成POCUS/CCU的委员会认证培训。55%的受访者在临床实践中经常使用POCUS/CCU，37%的受访者每周很少使用。分别有36%和42%的受访者认为自己在获取和解读POCUS/CCU图像方面技能中等。超声引导操作是受访者最常用的技术。大多数受访者认为使用超声评估容量状态、操作引导和休克情况会影响临床决策。对解读数据/影像缺乏信心以及进行POCUS/CCU操作时的舒适度是超声使用最常见的障碍。受访者同意将POCUS/CCU培训纳入NCC专科培训里程碑，并为POCUS/CCU资质认证的医护人员创建资源，以增加POCUS/CCU在NCC中的使用。
这项全国性调查表明，NCC医护人员对POCUS/CCU的使用程度中等。然而，NCC的学员和从业者需要更正规、更完善的POCUS/CCU培训，以提高使用超声进行临床评估的舒适度。
