A descriptive study of the use of cardiac point of care ultrasound (PoCUS) in public emergency centres in Cape Town.

Abstract

IntroductionThe indications for cardiac point of care ultrasound (PoCUS) vary somewhat in different parts of the world, and training programs may also differ. We set out to describe the self-reported cardiac PoCUS indications and imaging windows used at a selection of secondary-level, public hospital emergency centres in Cape Town.MethodsA descriptive study with prospective data collected from emergency centres of Mitchells Plain District, Victoria and New Somerset Hospitals in Cape Town were used. Data were collected over a three-month period by providers who have completed a basic emergency ultrasound course, using a purpose-designed data collection tool for all cardiac PoCUS scans.ResultsFifteen PoCUS providers recorded 267 data entries over the three-month study period; there were 17 exclusions, leaving 250 entries for analysis. The most common indication for performing cardiac PoCUS was electrocardiogram abnormalities, 27% (n = 112); dyspnoea, 25% (n = 102); chest pain, 16% (n = 65); cardiomegaly on chest x-ray, 12% (n = 51); new murmur, 6% (n = 23); and chest trauma, 5% (n = 22). Other indications made up the remaining 10% (n = 40). Parasternal long and short axis were the predominantly used views.ConclusionCardiac PoCUS is used for a wide range of indications beyond the recommended training guidelines. Some indications may be more useful in low- to middle-income settings. Further research needs to be done to ascertain the extent of the use of cardiac PoCUS, and possibly the need for a more comprehensive training program with adequate training in these clinical conditions, to ensure safe practice.