Use of ultrasound for non-trauma patients in the emergency department

In the past decade, there has been substantial knowledge translation in the use of ultrasound (US) by critical care physicians to aid diagnosis of the non-trauma patient. This study aimed to determine emergency doctors' level of training in ultrasonography, pattern of US use in regular practice and barriers to US use for the non-trauma patient presenting to an emergency department.

A survey on the use of US in non-trauma patients was conducted, targeting all emergency physicians and emergency medicine trainees in a single adult tertiary referral centre.

The response rate was 92.7% with 38 completed surveys analysed. A course in non-trauma US had been completed by 58% of respondents. The most common non-trauma formal US training was in vascular access (82%, 95% confidence interval [CI] 66.8-90.6), detection of abdominal aortic aneurysm (79%, 95% CI 63.7-88.9) and pericardial fluid (84%, 95% CI 69.6-92.6). Upon completion of formal training, US was used significantly more frequently for obtaining vascular access (odds ratio [OR] 12.0), detection of abdominal aortic aneurysms (OR 4.3) and detection of pericardial fluid (OR 15.5). Most doctors felt the greatest barriers to the use of US in the non-trauma patient were the lack of teaching, confidence in findings, experienced supervisors and time.

Among ED personnel, use of US to diagnose several non-traumatic conditions was low, but specific training was associated with significantly more US use. Increased training and availability of US-experienced supervisors might further improve utility of this important adjunct to the practice of emergency medicine.