Access to Point-of-Care Ultrasound in Maine Emergency Departments

Abstract

Introduction: Point-of-care ultrasound (POCUS) is an essential tool in emergency medicine. We evaluated access to bedside ultrasound machines and characterized POCUS use in Maine emergency departments (EDs). Methods: We conducted a cross-sectional electronic survey of all ED medical directors in Maine. The survey included questions on ED characteristics, access to ultrasound machines, POCUS use patterns, POCUS administration, and barriers to use. Results: Thirty-four EDs were identified, and 24 medical directors completed the survey, yielding a response rate of 71%. EDs were predominantly small and rural. Only 21% identified as urban, and 54% reported less than 20 000 annual visits. Surveys showed that 88% of EDs had immediate access to a bedside ultrasound machine in the ED. Also, 76% used ultrasound guidance to place more than 75% of internal jugular central venous catheters, while 24% used ultrasound to place less than 10% of catheters. Of EDs with ultrasound access, 90% had hospital privileges for providers, 71% had a credentialing process, 52% had quality assurance processes, and 48% had a designated ultrasound director. Discussion: Compared to other states, Maine EDs were lower-volume and more rural but had similar access to ultrasound machines. Previous studies showed poor adherence to national guidelines for ultrasound quality assurance practices and provider credentialing. Our results demonstrate that this issue is ongoing. Conclusions: Maine’s predominantly rural EDs have excellent access to ultrasound machines. Areas for improvement in POCUS use and administration were identified, including enhancing quality assurance practices, boosting provider credentialing, and increasing the use of ultrasound guidance for vascular access.