Ultrasound Guidelines: Emergency, Point-of-Care, and Clinical Ultrasound Guidelines in Medicine

doi:10.1016/j.annemergmed.2023.06.005

Cited by 21 publications

(8 citation statements)

References 265 publications

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“…The panel noted that ultrasound training occurring during foundational clinical programs might be considered “external,” but was not the intention of this statement. For example, clinical ultrasound is a mandatory element of modern emergency medicine residencies 9 , and the American College of Emergency Physicians (ACEP) has issued a policy statement asserting that external certification has no role for residency-trained emergency physicians 24 .…”

Section: Resultsmentioning

confidence: 99%

“…The American Medical Association’s resolution H-230.960 states that hospital requirements for POCUS credentialing for physicians should be guided by standards defined by that specialty, such as the well-established ACEP recommendations (which suggests emergency physicians undertake 25–50 quality-reviewed ultrasound studies in each application prior to independent practice) 9 , 25 . Mirroring this, the expert panel was unable to recommend any specific criteria applicable across both specialty type and resource setting (#14, #19).…”

Section: Resultsmentioning

confidence: 99%

“…Professional groups have released guidance on POCUS use in the form of guidelines, expert consensus statements, or practice recommendations, particularly from specialties with high levels of POCUS uptake, such as emergency medicine and critical care 1 , 2 , 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 . However, most guidelines have focused on evidence-based recommendations for the specific clinical uses of POCUS common to their specialty setting.…”

Section: Introductionmentioning

confidence: 99%

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Best Practices for Point of Care Ultrasound: An Interdisciplinary Expert Consensus

OTO,

Baeten,

Chen

et al. 2024

pocus

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Despite the growing use of point of care ultrasound (POCUS) in contemporary medical practice and the existence of clinical guidelines addressing its specific applications, there remains a lack of standardization and agreement on optimal practices for several areas of POCUS use. The Society of Point of Care Ultrasound (SPOCUS) formed a working group in 2022 to establish a set of recommended best practices for POCUS, applicable to clinicians regardless of their training, specialty, resource setting, or scope of practice. Using a three-round modified Delphi process, a multi-disciplinary panel of 22 POCUS experts based in the United States reached consensus on 57 statements in domains including: (1) The definition and clinical role of POCUS; (2) Training pathways; (3) Credentialing; (4) Cleaning and maintenance of POCUS devices; (5) Consent and education; (6) Security, storage, and sharing of POCUS studies; (7) Uploading, archiving, and reviewing POCUS studies; and (8) Documenting POCUS studies. The consensus statements are provided here. While not intended to establish a standard of care or supersede more targeted guidelines, this document may serve as a useful baseline to guide clinicians, leaders, and systems considering initiation or enhancement of POCUS programs.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Best Practices for Point of Care Ultrasound: An Interdisciplinary Expert Consensus

OTO,

Baeten,

Chen

et al. 2024

pocus

View full text Add to dashboard Cite

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“…The American College of Emergency Physicians states that US is an essential skill in emergency practice, and GB-US is included in 12 core applications [ 51 , 52 ]. It also indicates that 25 sonographic examinations of GB should be performed as a minimum requirement for training and accreditation [ 51 ]. In recent years, US has broadly used and increased integration into emergency practice.…”

Section: Discussionmentioning

confidence: 99%

Diagnostic performance of ultrasound in acute cholecystitis: a systematic review and meta-analysis

Huang,

Lin,

Liu

et al. 2023

World J Emerg Surg

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Background An updated overview of ultrasound (US) for diagnosis of acute cholecystitis (AC) remains lacking. This systematic review was conducted to evaluate the diagnostic performance of US for AC. Methods A systematic review was conducted following PRISMA guidelines. We meticulously screened articles from MEDLINE, Embase, and the Cochrane Library, spanning from inception to August 2023. We employed the search strategy combining the keywords "bedside US", "emergency US" or "point-of-care US" with "AC". Two reviewers independently screened the titles and abstracts of the retrieved articles to identify suitable studies. The inclusion criteria encompassed articles investigating the diagnostic performance of US for AC. Data regarding diagnostic performance, sonographers, and sonographic findings including the presence of gallstone, gallbladder (GB) wall thickness, peri-GB fluid, or sonographic Murphy sign were extracted, and a meta-analysis was executed. Case reports, editorials, and review articles were excluded, as well as studies focused on acalculous cholecystitis. The study quality was assessed with the Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) tool. Results Forty studies with 8,652 patients were included. The majority of studies had a low risk of bias and applicability concerns. US had a pooled sensitivity of 71% (95% CI, 69–72%), a specificity of 85% (95% CI, 84–86%), and an accuracy of 0.83 (95% CI, 0.82–0.83) for the diagnosis of AC. The pooled sensitivity and specificity were 71% (95% CI, 67–74%) and 92% (95% CI, 90–93%) performed by emergency physicians (EPs), 79% (95% CI, 71–85%) and 76% (95% CI, 69–81%) performed by surgeons, and 68% (95% CI 66–71%) and 87% (95% CI, 86–88%) performed by radiologists, respectively. There were no statistically significant differences among the three groups. Conclusion US is a good imaging modality for the diagnosis of AC. EP-performed US has a similar diagnostic performance to radiologist-performed US. Further investigations would be needed to investigate the impact of US on expediting the management process and improving patient-centered outcomes.

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“…Although US has become a powerful tool for treating clinicians, it is dependent on the user’s skills and training. A great push towards the importance of training and standardized educational curriculum has been made through national guidelines publications [ 14 , 15 ]. Despite this, at present, a standardization of training pathways for both pediatric residents and faculty has not been established and US curricula and credentialing processes deeply vary worldwide [ 10 , 16 , 17 ].…”

Section: Introductionmentioning

confidence: 99%

Pediatric ultrasound practice in Italy: an exploratory survey

Musolino,

Tei,

De Rose

et al. 2024

Ital J Pediatr

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Background The aim of this exploratory survey is to describe the current state of US (ultrasound) technique across different pediatric settings nationwide. Methods A questionnaire was emailed to all members of the Italian Society of Pediatrics, including pediatric residents. The survey was open from December 2021 to March 2022. Results There were 1098 respondents. Seven hundred and seven pediatricians (84.1%) reported any use of US, while 51 (44.3%) residents denied it. The majority of participants (n = 956, 87.1%) reported to have a US machine available within the department, mostly cart-based (n = 516, 66.9%) and provided from 1 to 5 years prior to the survey (n = 330, 42.8%). Lung and neonatal cerebral regions were the most frequently scanned (n = 289, 18.7% and n = 218, 14.1%, respectively). The suspicion of pneumonia or respiratory distress represented the main reasons for performing US in emergency room (n = 390, 78% and n = 330, 66%, respectively). The majority of family pediatricians reported to scan lung and kidney/urinary tract regions (n = 30, 16.9%, and n = 23,12.9%, respectively). Regarding US training, the majority of respondents (n = 358, 34.6%) declared an experience-based education, with a deficient certification enabling the use of US in 71.6% (n = 552) of cases. The most common barriers included the lack of a well-defined training program (n = 627, 57.1%), unavailability of the US machine (n = 196, 17.9%) and legal responsibility concern (n = 175, 15.9%). Conclusions Despite the growing interest on pediatric US nationally, significant barriers still limit widespread adoption. These obstacles may be addressed through the dissemination of a specific US education plan and providing additional resources.

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Ultrasound Guidelines: Emergency, Point-of-Care, and Clinical Ultrasound Guidelines in Medicine

Cited by 21 publications

References 265 publications

Best Practices for Point of Care Ultrasound: An Interdisciplinary Expert Consensus

Best Practices for Point of Care Ultrasound: An Interdisciplinary Expert Consensus

Diagnostic performance of ultrasound in acute cholecystitis: a systematic review and meta-analysis

Pediatric ultrasound practice in Italy: an exploratory survey

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