Utilization of Emergency Ultrasound in Pediatric Emergency Departments

Abstract

This study aimed to determine the utilization of emergency ultrasound (EUS) in pediatric emergency departments (EDs) and in pediatric emergency medicine (PEM) fellowship training programs and to assess if PEM fellowship programs provided formal training in EUS. A Web-based survey was administered to pediatric emergency medical directors, fellowship directors, and graduating fellows. A response was received from 60% of individuals and 68% of institutions. Of the responders, 27% reported that their institution had a EUS program. Also, 96% of the responders reported having a dedicated US machine in the ED, but only 61% reported using EUS for managing ED patients. Responders reported using EUS for the focused assessment by sonography for trauma examination (93%), abscess management (82%), vascular access (78%), bladder scanning (70%), cardiac activity confirmation (59%), and pericardial effusion detection (59%). For pediatric emergency staff physicians, 63% of the responders reported obtaining EUS training from general emergency physicians and 59% from a commercial ultrasound course and from pediatric emergency physicians. For PEM fellows, 34% reported having a standardized EUS training program. Of the responders, 69% reported receiving training from general emergency physicians during adult ED rotations and 38% reported receiving training from pediatric emergency physicians. Only 28% of programs reported using criteria established by the American College of Emergency Physicians for the number of scans performed to attain competence. In our study sample, there is wide variation in the uses of EUS and the training pediatric emergency physicians receive in its use.