Point-of-care ultrasonography (POCUS) is the process of operating a compact ultrasound machine at a patient's location and immediately integrating the images generated into patient care. POCUS can help nurse practitioners (NPs) make more accurate diagnoses, facilitate safer procedures, and bridge health care access gaps in resource-limited settings such as primary care; however, it is widely agreed that POCUS is operator-dependent and that appropriate education is required to competently operate the device. This integrative review sought to determine what education NPs need to competently operate POCUS in primary care and it was found that there is no data specific to NPs; much of the available information is instead within the medical literature. Given the numerous benefits of POCUS for improving patient care and health care systems efficiency, NPs must urgently determine their POCUS education needs as they have ethical and legal obligations, in addition to a professional responsibility to ensure safe, highquality patient care.
A 67-year-old is brought to your resuscitation room in your emergency department. She is in acute distress and has a blood pressure of 211/120, a heart rate of 130 per minute, a respiratory rate of 31 breaths per minute, and an oxygen saturation of 88% on room air. You are about to call for a portable chest radiograph, but the emergency nurse practitioner reaches for the point-of-care ultrasound machine, puts the probe on the patient’s chest, and in under a minute, states: “I see B-lines and weak cardiac contractility; there is normal lung sliding.”
A 44-year-old driver of a small sedan self-presents to your emergency department (ED) triage area indicating they developed a stiff neck 30 minutes after they were rear-ended by a small van when they were stopped at a traffic light. The rear bumper of the patient’s vehicle is slightly dented, and there is scuffing to the front bumper of the van. No airbags were deployed and the driver of the sedan did not hit their head. The van was estimated to be travelling between 10-20 km/h at the time of impact. The patient self-extricated from their vehicle and was ambulatory at the scene. Currently, the patient is alert, oriented, and in no distress. The patient denies paresthesia, has no midline cervical spine (c-spine) tenderness, and is able to actively rotate their neck 45° left and right.
The Ottawa Ankle Rule (OAR) is a clinical decision-making tool to help guide clinicians’ decision to obtain an ankle radiograph (x-ray) to rule out a clinically significant ankle or foot fracture among patients who have suffered a blunt, traumatic injury (Stiell et al., 1992). The Ottawa Ankle Rule (OAR) carries a 100% sensitivity for ankle or foot fractures (Stiell et al., 1992) and has been validated for use in multiple studies (Sperry et al., 1999; Stiell et al., 1993). Subsequent studies have found that the OAR can be applied to children aged 2–16 years presenting to the emergency department (ED) with similarly high sensitivity (Plint et al., 1999).
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