Point-of-care Ultrasonography by Pediatric Emergency Medicine Physicians.

Abstract

In 2001 the American College of Emergency Physicians (ACEP) first published specialty-specific guidelines for point-of-care ultrasound (US) in emergency medicine (EM). At the same time, the Accreditation Council for Graduate Medical Education mandated that EM residents graduate with competency in point-of-care US. The guidelines and call for competency have since gained broad professional society acceptance.1-6 Several of the point-of-care US applications described in the ACEP guidelines and in the EM literature are not necessarily relevant to the practice of pediatric EM (PEM). In addition, there are applications that have not been well delineated in EM and are applicable to PEM practitioners. To date, the majority of PEM physicians have completed pediatrics residencies without point-of-care US training. In addition, point-of-care US only recently became a core competency for PEM fellowship training.7 Consequently, PEM as a specialty has been slower to adopt and incorporate point-of-care US into clinical practice. Over the past several years, point-of-care US has gained acceptance by PEM providers. There is a dedicated PEM point-of-care textbook,8 PEM fellowship training guidelines,7 and an organization devoted to PEM point-of-care US providers (www.P2network.com). Moreover, PEM physician use of point-of-care US has increased dramatically. Specifically, 95% of emergency departments with a PEM fellowship program incorporate point-of-care US into patient care, and 88% provide training for PEM fellows.9 The demand for training is increasing, and as of 2015 there are 12 PEM-specific US fellowships.10 This month, the American Academy of Pediatrics (AAP) published the first guideline for point-of-care US use by PEM physicians. The AAP policy statement11 and accompanying technical report12 provide background and a framework for PEM physicians, who currently use or are planning to incorporate point-of-care US into their practice. The documents represent a joint effort by the AAP, the Society for Academic Emergency Medicine, ACEP, and the World Interactive Network Focused on Critical Ultrasound.