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The Use of Point-of-Care Ultrasound in Pediatric Emergency Departments and Intensive Care Units: A Descriptive Study
Nihan Şık1, Gazi Arslan2, Ayla Akca Çağlar3
1From the Pediatric Emergency Department, Balikesir Ataturk City Hospital, Balikesir, Turkey.
Insights
Point-of-care ultrasound (POCUS) is widely used in Turkish pediatric emergency departments and intensive care units, but barriers like lack of training and equipment hinder its full potential. Mandatory POCUS education is recommended for fellows.
Area of Science:
- Pediatric Emergency Medicine
- Pediatric Critical Care
- Point-of-Care Ultrasound (POCUS)
Background:
- Point-of-care ultrasound (POCUS) is increasingly recognized for its utility in pediatric emergency departments (PEDs) and pediatric intensive care units (PICUs).
- Understanding the current adoption, perceptions, and challenges of POCUS in these specialized pediatric settings in Turkey is crucial for optimizing its use.
Purpose of the Study:
- To assess the current status of POCUS implementation in Turkish PEDs and PICUs.
- To evaluate healthcare professionals' perceptions, educational approaches, and identified barriers related to POCUS utilization.
- To identify key areas for improvement in POCUS training and accessibility.
Main Methods:
- A descriptive, multicenter, cross-sectional study was conducted using an online survey.
- The survey was distributed via the Turkish Society of Pediatric Emergency and Intensive Care email list.
- Responses were collected from clinical chiefs of PEDs and PICUs using the REDCap platform.
Main Results:
- POCUS is clinically utilized in 84.2% of PEDs and 100% of PICUs surveyed.
- Thoracic and cardiovascular assessments were primary diagnostic uses, while vascular access and thoracentesis were key procedural applications.
- Key barriers identified include lack of equipment, insufficient manpower, low awareness, and inadequate training, with strong agreement for mandatory fellowship training.
Conclusions:
- While awareness of POCUS benefits is high, significant barriers related to education, equipment, and staffing impede widespread adoption in Turkish PEDs and PICUs.
- Enhancing POCUS accessibility through increased device availability, dedicated personnel, and expanded educational programs is essential for its further promotion.
Objectives:
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.
Methods:
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.
Results:
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.
Conclusions:
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.
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