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Point-of-Care Ultrasound in Pediatric Hospital Medicine: A National Survey
Kevin Weinberger1,2, Mary Esther M Rocha1, Colleen Keough1
1Baylor College of Medicine, Department of Pediatrics, Division of Pediatric Hospital Medicine, Texas Children's Hospital, Houston, Texas.
Insights
Point-of-care ultrasonography (POCUS) is used by over 1 in 6 pediatric hospital medicine (PHM) divisions in the US. Key applications include diagnosing common inpatient conditions and guiding procedures, with barriers to wider use identified.
Area of Science:
- Pediatric Hospital Medicine
- Point-of-Care Ultrasonography (POCUS)
- Medical Education and Training
Background:
- Pediatric hospital medicine (PHM) is increasingly adopting advanced diagnostic tools.
- Point-of-care ultrasonography (POCUS) offers rapid, non-invasive bedside assessments.
- Understanding POCUS adoption in PHM is crucial for optimizing patient care and training.
Purpose of the Study:
- To evaluate the current utilization of POCUS in US PHM groups.
- To identify barriers and facilitators to POCUS implementation and expansion.
- To delineate the clinical applications of POCUS within PHM settings.
Main Methods:
- A multicenter, cross-sectional survey was distributed to PHM groups nationwide via the Pediatric Research in Inpatient Setting (PRIS) Network.
- Descriptive and inferential statistics analyzed POCUS program prevalence, characteristics, applications, barriers, and facilitators.
- Responses from 54% of surveyed sites (n=97) were included in the analysis.
Main Results:
- 17% of responding PHM divisions (n=9) reported active POCUS programs.
- No significant differences in POCUS implementation were found based on location, setting, or hospital size.
- Common POCUS uses included diagnosing pleural effusions, pneumonia, pericardial effusions, and guiding lumbar punctures.
- Programs with POCUS had dedicated leaders (100%), equipment (78%), and institutional training (67%).
- Barriers for non-adopting groups included lack of local experts, equipment, and cost concerns.
Conclusions:
- In 2024, POCUS is actively integrated into patient care by over 16% of surveyed PHM divisions.
- The clinical applications of POCUS in PHM are diverse and relevant to common inpatient pediatric diagnoses.
- Addressing identified barriers is key to facilitating broader POCUS implementation in PHM.
Objective:
To assess the current use, barriers, facilitators, and clinical applications of point-of-care ultrasonography (POCUS) within pediatric hospital medicine (PHM) groups across the United States, aiming to identify opportunities for broader implementation.
Methods:
Using the Pediatric Research in Inpatient Setting (PRIS) Network, we conducted an anonymous, multicenter, cross-sectional survey targeting PHM groups in both academic children's hospitals and community settings. Descriptive and inferential statistics were used to identify the proportion of PHM divisions using POCUS, the associated characteristics of these groups, their current POCUS applications, and the barriers and facilitators for POCUS implementation.
Results:
Of the 97 sites surveyed, 56% (n = 54) responded. Of these, 17% (n = 9) reported having a POCUS program. There was no significant difference in POCUS implementation among PHM divisions concerning geographic location, practice setting, number of beds, or faculty. Programs utilizing POCUS identified the following as principle uses: diagnosis of pleural effusions, pneumonia, pericardial effusions, bladder volume, and skin and soft tissue infections and performance of lumbar punctures. Among PHM groups with a POCUS program, 100% had a trained POCUS leader, 78% had dedicated equipment for their division, and 67% had available institutional training for their PHM group. The top barriers identified by PHM groups without a POCUS program included a lack of local POCUS experts, lack of equipment, and cost of equipment.
Conclusion:
In 2024, more than 1 in 6 PHM divisions responding to this survey actively incorporated POCUS in the care of patients. These applications are diverse and applicable across common inpatient diagnoses.
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