Access to and Use of Point-of-Care Ultrasound in the Emergency Department
Introduction: Growing evidence supports emergency physician (EP)-performed point-of-care ultrasound (PoC US). However, there is a utilization gap between academic emergency departments (ED) and other emergency settings. We elucidated barriers to PoC US use in a multistate sample of predominantly...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
eScholarship Publishing, University of California
2015-10-01
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| Series: | Western Journal of Emergency Medicine |
| Online Access: | http://escholarship.org/uc/item/3hh4v532 |
| _version_ | 1818567026503843840 |
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| author | Jason L. Sanders Vicki E. Noble Ali S. Raja Ashley F. Sullivan Carlos A. Camargo, Jr |
| author_facet | Jason L. Sanders Vicki E. Noble Ali S. Raja Ashley F. Sullivan Carlos A. Camargo, Jr |
| author_sort | Jason L. Sanders |
| collection | DOAJ |
| description | Introduction: Growing evidence supports emergency physician (EP)-performed point-of-care
ultrasound (PoC US). However, there is a utilization gap between academic emergency departments
(ED) and other emergency settings. We elucidated barriers to PoC US use in a multistate sample
of predominantly non-academic EDs to inform future strategies to increase PoC US utilization,
particularly in non-academic centers.
Methods: In 2010, we surveyed ED directors in five states (Arkansas, Hawaii, Minnesota,
Vermont, and Wyoming; n=242 EDs) about general ED characteristics. In four states we
determined barriers to PoC US use, proportion of EPs using PoC US, use privileges, and
whether EPs can bill for PoC US.
Results: Response rates were >80% in each state. Overall, 47% of EDs reported PoC US
availability. Availability varied by state, from 34% of EDs in Arkansas to 85% in Vermont. Availability
was associated with higher ED visit volume, and percent of EPs who were board certified/board
eligible in emergency medicine. The greatest barriers to use were limited training (70%), expense
(39%), and limited need (perceived or real) (32%). When PoC US was used by EPs, 50% used it
daily, 44% had privileges not requiring radiology confirmation, and 34% could bill separately for PoC
US. Only 12% of EPs used it ≥80% of the time when placing central venous lines.
Conclusion: Only 47% of EDs in our five-state sample of predominantly non-academic EDs had
PoC US immediately available. When available, the greatest barriers to use were limited training,
expense, and limited need. Recent educational and technical advancements may help overcome
these barriers. |
| first_indexed | 2024-12-14T06:18:10Z |
| format | Article |
| id | doaj.art-3a8a8eca495046bd9fbfd5a47e1f4972 |
| institution | Directory Open Access Journal |
| issn | 1936-900X 1936-9018 |
| language | English |
| last_indexed | 2024-12-14T06:18:10Z |
| publishDate | 2015-10-01 |
| publisher | eScholarship Publishing, University of California |
| record_format | Article |
| series | Western Journal of Emergency Medicine |
| spelling | doaj.art-3a8a8eca495046bd9fbfd5a47e1f49722022-12-21T23:13:57ZengeScholarship Publishing, University of CaliforniaWestern Journal of Emergency Medicine1936-900X1936-90182015-10-0116574775210.5811/westjem.2015.7.27216Access to and Use of Point-of-Care Ultrasound in the Emergency DepartmentJason L. Sanders0Vicki E. Noble1Ali S. Raja2Ashley F. Sullivan3Carlos A. Camargo, Jr4Massachusetts General Hospital, Department of Emergency Medicine, Boston, Massachusetts Massachusetts General Hospital, Department of Emergency Medicine, Boston, Massachusetts Massachusetts General Hospital, Department of Emergency Medicine, Boston, Massachusetts Massachusetts General Hospital, Department of Emergency Medicine, Boston, Massachusetts Massachusetts General Hospital, Department of Emergency Medicine, Boston, Massachusetts Introduction: Growing evidence supports emergency physician (EP)-performed point-of-care ultrasound (PoC US). However, there is a utilization gap between academic emergency departments (ED) and other emergency settings. We elucidated barriers to PoC US use in a multistate sample of predominantly non-academic EDs to inform future strategies to increase PoC US utilization, particularly in non-academic centers. Methods: In 2010, we surveyed ED directors in five states (Arkansas, Hawaii, Minnesota, Vermont, and Wyoming; n=242 EDs) about general ED characteristics. In four states we determined barriers to PoC US use, proportion of EPs using PoC US, use privileges, and whether EPs can bill for PoC US. Results: Response rates were >80% in each state. Overall, 47% of EDs reported PoC US availability. Availability varied by state, from 34% of EDs in Arkansas to 85% in Vermont. Availability was associated with higher ED visit volume, and percent of EPs who were board certified/board eligible in emergency medicine. The greatest barriers to use were limited training (70%), expense (39%), and limited need (perceived or real) (32%). When PoC US was used by EPs, 50% used it daily, 44% had privileges not requiring radiology confirmation, and 34% could bill separately for PoC US. Only 12% of EPs used it ≥80% of the time when placing central venous lines. Conclusion: Only 47% of EDs in our five-state sample of predominantly non-academic EDs had PoC US immediately available. When available, the greatest barriers to use were limited training, expense, and limited need. Recent educational and technical advancements may help overcome these barriers.http://escholarship.org/uc/item/3hh4v532 |
| spellingShingle | Jason L. Sanders Vicki E. Noble Ali S. Raja Ashley F. Sullivan Carlos A. Camargo, Jr Access to and Use of Point-of-Care Ultrasound in the Emergency Department Western Journal of Emergency Medicine |
| title | Access to and Use of Point-of-Care Ultrasound in the Emergency Department |
| title_full | Access to and Use of Point-of-Care Ultrasound in the Emergency Department |
| title_fullStr | Access to and Use of Point-of-Care Ultrasound in the Emergency Department |
| title_full_unstemmed | Access to and Use of Point-of-Care Ultrasound in the Emergency Department |
| title_short | Access to and Use of Point-of-Care Ultrasound in the Emergency Department |
| title_sort | access to and use of point of care ultrasound in the emergency department |
| url | http://escholarship.org/uc/item/3hh4v532 |
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