Thorne Catriana R, Shaughnessy Colin, Adelson Lindsay, Cannata David, Orosco Emily, Rong Katie, Kostyun Regina, Herbst Meghan Kelly
University of Connecticut School of Medicine Farmington Connecticut USA.
Department of Emergency Medicine University of Connecticut School of Medicine Farmington Connecticut USA.
AEM Educ Train. 2025 May 14;9(3):e70051. doi: 10.1002/aet2.70051. eCollection 2025 Jun.
Despite mandatory point-of-care ultrasound (PoCUS) training in residency, utilization varies across emergency departments (EDs). We sought to characterize PoCUS utilization patterns in the United States, specifically comparing academic to nonacademic settings.
A nationwide cross-sectional survey was conducted from March to November 2024, targeting general EDs open 24/7. Site directors completed a 15-question survey on PoCUS use, workflow, and billing. Academic EDs (those with emergency medicine residents or ultrasound fellows) were compared to nonacademic EDs. Regular PoCUS use for a physician was defined as using two or more applications at least once per week; regular PoCUS use for an application was defined as at least one scan per week. A strong workflow required image storage to Picture Archiving and Communication System/Middleware and physician review. Differences in PoCUS utilization, workflow, and billing were analyzed using chi-square, Mann-Whitney , and unpaired -tests. Correlations between study variables and ED academic status were assessed using Pearson's and Spearman's coefficients. Odds ratios (ORs) measured the strength of associations.
Of 664 invited EDs (15.3% of all U.S. EDs), 423 completed surveys (63.8% response rate) from all 50 states and Washington, DC. Academic EDs ( = 220) were more likely to own four or more ultrasound machines (54.1%) compared to nonacademic EDs (54.2% owned ≤1, < 0.001). More physicians performed ultrasound regularly at academic sites (58.7% ± 28.1%) versus nonacademic sites (46.7% ± 27.2%, p < 0.001), but there was no association between recent residency training and ultrasound utilization ( = -0.008, = 0.875). Academic EDs had stronger workflow integration (OR 3.9, 95% confidence interval [CI] 2.6-5.9, < 0.001) and were more likely to bill for PoCUS (OR 3.8, 95% CI 2.4-6.0, < 0.001).
PoCUS utilization is lower in nonacademic EDs, with suboptimal workflows and fewer billing practices. Addressing these disparities may enhance PoCUS implementation and improve patient care.
尽管住院医师培训中有强制的床旁超声（PoCUS）培训，但各急诊科（ED）的使用情况存在差异。我们试图描述美国PoCUS的使用模式，特别是比较学术性与非学术性机构的情况。
于2024年3月至11月进行了一项全国性横断面调查，目标是每周7天、每天24小时开放的普通急诊科。各机构主任完成了一项关于PoCUS使用、工作流程和计费的15个问题的调查。将学术性急诊科（有急诊医学住院医师或超声专科住院医师的科室）与非学术性急诊科进行比较。医生定期使用PoCUS的定义为每周至少使用两次或更多应用程序；应用程序定期使用的定义为每周至少进行一次扫描。强大的工作流程要求将图像存储到图像存档与通信系统/中间件并由医生进行审核。使用卡方检验、曼-惠特尼检验和非配对t检验分析PoCUS使用、工作流程和计费方面的差异。使用皮尔逊系数和斯皮尔曼系数评估研究变量与急诊科学术地位之间的相关性。比值比（OR）衡量关联强度。
在664家受邀的急诊科（占美国所有急诊科的15.3%）中，来自所有50个州和华盛顿特区的423家完成了调查（回复率为63.8%）。与非学术性急诊科相比（54.2%拥有≤1台，p<0.001），学术性急诊科（n=220）更有可能拥有四台或更多超声设备（54.1%）。在学术性机构，更多医生定期进行超声检查（58.7%±28.1%），而非学术性机构为（46.7%±27.2%，p<0.001），但近期住院医师培训与超声使用之间没有关联（r=-0.008，p=0.875）。学术性急诊科的工作流程整合更强（OR 3.9，95%置信区间[CI] 2.6-5.9，p<0.001），并且更有可能为PoCUS计费（OR 3.8，95% CI 2.4-6.0，p<0.001）。
非学术性急诊科的PoCUS使用较低，工作流程欠佳，计费做法较少。解决这些差异可能会促进PoCUS的实施并改善患者护理。
