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Keywords:

  • Australia;
  • credentialing;
  • education;
  • emergency medicine;
  • ultrasonography

Abstract

Objective

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.

Method

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.

Results

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.

Conclusions

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.