Rural Canadian emergency physician experiences using point-of-care ultrasound

Point-of-care ultrasound (POCUS) is a rapidly evolving and clinically significant skill set that has potential for improving patient care for the approximately 7 million Canadians living in rural and under-resourced environments. A national appraisal of rural POCUS training and utilization is needed to understand barriers to funding and training for rural emergency physicians in Canada. The primary objective of this study was to determine the current level of training and types of POCUS utilization by rural emergency physicians in Canada. The secondary objective was to describe the barriers to POCUS use.

An online survey of POCUS education, training, and utilization was distributed, in English and French, to rural emergency physicians across Canada via the Canadian Association of Emergency Physicians, Society of Rural Physicians of Canada and College of Family Physicians of Canada listservs.

One hundred and sixty-eight physicians completed the survey with a response rate of 10%. Most were family physicians registered with the College of Family Physicians of Canada (68%) and worked in rural communities with under 10,000 residents (64%). The majority of respondents (94%) used a POCUS device in their practice, with 40% always using POCUS and 84% having access to a high-quality device. POCUS was commonly used for abdominal aortic aneurysm, cardiac, and obstetrical exams. Key barriers to training were cost (62%), distance to the training center (48%), inability to take time off work (43%) and insufficient hospital administration support (21%). Eighty percent of respondents agreed that POCUS was valuable in rural and remote areas with limited access to diagnostic imaging and 78% agreed that institutions should fund POCUS training.

POCUS is used daily for patient care in rural Canadian emergency departments. Despite widespread access to POCUS, rural emergency physicians face significant barriers in training and utilization.