Recommendations on actions to avoid when performing point-of-care ultrasound in pediatric emergency departments
Roser Martínez-Mas1, Adrián Ranera Málaga2, Fidel Gallinas-Victoriano3
1Pediatric Emergency Department, Cruces University Hospital, BioCruces Bizkaia Health Research Institute, Barakaldo, Spain; Coordinator of the Working Group on Clinical Ultrasound of the Spanish Society of Pediatric Emergency Medicine. Cruces Plaza, s/n, 48903 Barakaldo, Bizkaia, Spain.
Background:
Contrary to the classic method of learning from experts and gradually assuming responsibility, a new trend that identifies the most common mistakes and common misconceptions is proving to be very beneficial in learning medical procedures such as Point-of-care ultrasound (POCUS) for both less experienced and more experienced professionals.
Objective:
To present the elaboration process and results of the list of actions to avoid in Point-of-Care Ultrasound (POCUS) use in the pediatric emergency department (PED) within the Working Group on Clinical Ultrasound of the Spanish Society of Pediatric Emergency Medicine (GTEC-SEUP).
Methods And Settings:
The process was carried out in 3 phases: (1) "Brainstorming", open to all GTEC-SEUP members; (2) Selection of recommendations, following a modified Delphi methodology. Participants were asked to rank the recommendations (from 1="total disagreement" to 9="total agreement"). Recommendations with an average score ≥8 (and ranked a minimum of 7 by at least 2/3 of participants) were accepted, and those with an average score <6 were rejected. Doubtful recommendations (not meeting accepted or rejected criteria) were submitted to a second round of evaluation; (3) Drafting and consensus of the final document.
Results:
40 proposals for "actions to avoid" were retrieved, which were reduced to 33 after unifying and eliminating similar proposals. After the first round, 8 recommendations were accepted and 2 rejected. After the second round of evaluation, one more recommendation was accepted. The final document includes 9 recommendations: 4 referring to general principles of POCUS and 5 to specific POCUS applications: lung, Focused Assessment with Sonography for Trauma, focused cardiac, cardiac arrest, and skull POCUS.
Conclusions:
The list of "actions to avoid" in POCUS use in the PED is a consensual tool within the GTEC-SEUP. These recommendations advocate for a standardized and rational utilization of POCUS, promoting an improvement in safety and efficacy in the PED.
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