The Use of Point-of-Care Ultrasound in Pediatric Emergency Departments and Intensive Care Units: A Descriptive Study From Turkey.

Abstract

The aim was to evaluate the current status of point-of-care ultrasound (POCUS), perceptions, education, training, and barriers to using POCUS in pediatric emergency departments (PEDs) and pediatric intensive care units (PICUs) in Turkey. A descriptive, multicenter, cross-sectional study through an online survey was developed using the REDCap online platform. The survey was distributed through the Turkish Society of Pediatric Emergency and Intensive Care e-mail group. Each survey was answered only once by each PED/PICU and by the clinical chief of the department. A total of 19 PEDs and 26 PICUs responded to the survey. Among them, 84.2% of PEDs and 100% of PICUs reported the clinical use of POCUS. For diagnostic applications, the most common areas for PEDs and PICUs were thoracic (93.7%/100%) and cardiovascular (62.5%/65.4%) assessment, and in the procedural use of POCUS, the most frequent applications were those for vascular access (75.0%/92.3%) and thoracentesis (31.2%/65.4%). The most commonly reported clinical benefits were rapid diagnosis, rapid treatment, and decreased complications during procedural applications for PEDs and PICUs. Evaluating the barriers to POCUS use in PEDs and PICUs, the most common reasons for insufficient use were the lack of ultrasound machines and/or equipment, a shortage of manpower, lack of awareness, and lack of training. For PEDs (68.4%) and for PICUs (84.6%), participants agreed that POCUS training should be mandatory during fellowship programs. Most participants were aware of the need for POCUS. However, lack of education, equipment, manpower, and infrastructure still emerged as barriers to the use of POCUS. To further promote POCUS use, it would be helpful to improve accessibility by ensuring sufficient numbers of ultrasound devices together with sufficient numbers of appointed physicians and by expanding POCUS education in PEDs and PICUs.