Both NPM and PCCM fellowship programs believe in the benefits of POCUS and that their physicians should receive the necessary training. Compared with PCCM, NPM fellowships programs have less access to POCUS machines and less frequently use POCUS and train their fellows and attendings. There remain significant barriers to utilization of POCUS, especially in NPM.

US for ETT verification appears to be well tolerated in infants and children and may augment determination of proper ETT position in combination with other ETT verification modalities. Further studies are needed regarding technique and training. What is Known: • Point-of-care ultrasonography is realizing increased availability and use in several pediatric specialties. • Ultrasonography has been shown to be effective for verifying ETT position in adults but have been less studied in infants and children. What is New: • Ultrasonography for endotracheal tube verification appears to be well tolerated in infants and children. • Ultrasonography may augment determination of proper endotracheal tube position in combination with other verification modalities such as radiography and capnography in the pediatric population.

This study of a major legal database suggests that POCUS use and interpretation is not a significant cause of lawsuits against neonatologists and PSS.

Ultrasonography (US) has been shown to be effective for verifying endotracheal tube (ETT) position in adults and older children but has been less studied in the neonates and infants. The literature regarding US utility for ETT positioning in this population is reviewed. A literature search was conducted using the EMBASE, Google Scholar, MEDLINE, Ovid, and Scopus databases with search terms regarding US relating to ETT intubation and positioning in neonates and infants. Nine relevant studies were included for review. All studies report > 80% visualization of the ETT tip by US. US interpretation of the ETT position correlated with the radiography position in 73 to 100% of cases when the ETT tip was visible. There were variations in technique, sonographer, and sonographer training between studies. US appears to be well tolerated by neonates and infants and may augment the determination of proper ETT position. Further studies are needed regarding optimal technique and sonographer training.

Objective Central catheters (CCs) are routinely used in the neonatal intensive care unit (NICU). Ultrasonography (US) has been advocated as a procedural adjunct for CC placement to better localize catheter tip position (CTP), minimize radiation exposure, and decrease procedural burden. This review evaluates the clinical benefit, practical considerations for implementation, and limitations of US for CC placement in the NICU. Study Design A literature search was conducted using the Pubmed and Ovid databases with search terms regarding the ultrasound modality relating to CCs in infants and neonates. Results Five studies regarding US-guided CC insertions and seven studies describing postinsertion US were determined pertinent to this review's objective and discussed. Conclusions At this time, the literature seems insufficient to recommend US as a replacement for radiography for CTP confirmation; however, US-guidance during insertion followed by radiographic verification can decrease line manipulations and repeat radiographs. Postinsertion assessments by US can better determine the CTP and guide repositioning decisions, reducing the likelihood of malposition and potential complications, and may be more practical for many NICUs. However, it is unclear how much training and experience is necessary to deem an individual competent for reliable and clinically beneficial bedside US evaluations.

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A Web-based teaching device was constructed to deliver information on fundamentals of ultrasound imaging to approximately onehalf the students in an undergraduate medical imaging course, while the remaining students were taught the same material via traditional lectures and typed notes. The students participating in this study were separated randomly but in such a manner that prior achievement was statistically equivalent for the two groups. After approximately two weeks of instruction, an ultrasound imaging exam was administered. Results indicated no statistically significant difference in scores on homework assigned during the instructional period between the traditional and online groups. Similarly, there was no statistically significant difference in the average exam scores of students in the two groups. The traditional group required significantly more time on learning activities than did the online group. These results indicated that level of understanding was not affected by use of the online device, while efficiency of learning improved dramatically. Reasons reported by the students for the improved efficiency of the online method included flexibility in time usage and ability to cater to the individual, which came with the added responsibility of self-discipline. The traditional teaching method, meanwhile, allowed interaction with and instant feedback from a professor and other students. In this study we have demonstrated that the nature of an online device yields a higher level of efficiency than traditional lectures, despite the inherent drawbacks of the approach. The effectiveness of this device could potentially be improved by implementing enhancements to increase the level of interaction for the user and to help with discipline and time management.