Bedside ultrasound in the pediatric emergency department

Levy, Jason A.; Bachur, Richard G.

doi:10.1097/mop.0b013e3282ff1317

Cited by 25 publications

(23 citation statements)

References 73 publications

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“…Although this might represent a familiar sentiment, the body of literature to support the use of POCUS in PEM is becoming more and more robust and includes literature that supports the use of POCUS for assessment of heart and lung pathologies, intussusception, hypertrophic pyloric stenosis, appendicitis, long bone fractures, skull fractures, skin and soft tissue infection, and procedural guidance. [7][8][9]17 The majority of fellows stated that they would like to incorporate a CEUS course (70% for emergency department echography [EDE] 1, 54% for EDE 2) as part of their POCUS curriculum, whereas 30% asked for "other" courses (the latter included pediatric POCUS courses). This response suggests that the majority of sites still lack the capacity to incorporate POCUS into their curriculum due to a lack of local expertise or instructional infrastructure and are dependent on third-party training.…”

Section: Discussionmentioning

confidence: 99%

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Emergency point-of-care ultrasound in Canadian pediatric emergency fellowship programs: current integration and future directions

Hoeffe

Desjardins

Fischer

et al. 2016

CJEM

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Background: Adult and pediatric emergency physicians have been using point-of-care ultrasound (POCUS) for many years. It is a fast, usually painless, noninvasive diagnostic tool that does not expose the patient to radiation. Information about its current implementation in pediatric emergency medicine (PEM) fellowship programs in Canada is lacking. Objective: The main goal of our study was to investigate current integration and future direction of POCUS training in Canadian PEM programs. Methods: The study consisted of two surveys designed for fellows and program directors of all Canadian PEM fellowship programs. The major aspects of the survey were 1) to describe current training in POCUS in fellowship programs, 2) to compare the kind of training that programs offer with what fellows actually receive, and 3) a needs assessment by fellows and program directors for future POCUS training programs. Surveys were sent to program directors and passed on to their fellows. Results: Ninety percent of fellowship program directors as well as 70% (42/60) of fellows responded to the survey. A formal POCUS curriculum exists in five of the nine PEM programs included in this study. Three programs offer specific pediatric POCUS training. The main application is the FAST (focused assessment with sonography for trauma) exam. Conclusion: There is a wide variation in POCUS content and delivery across PEM fellowship programs, as well as differences in perceptions of current training and of needs by fellows and program directors. However, given that both groups feel POCUS is very important and essential for PEM training, the opportunity exists to develop a standardized curriculum across Canada.

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Section: Discussionmentioning

confidence: 99%

“…[1][2][3][4][5] More recently, POCUS has been integrated into pediatric emergency medicine (PEM) practice. [6][7][8][9][10] The technology is appealing for PEM because it is usually painless, radiation free, potentially accessible, and valuable for augmenting both clinical decision-making and therapeutic intervention.…”

Section: Introductionmentioning

confidence: 99%

Emergency point-of-care ultrasound in Canadian pediatric emergency fellowship programs: current integration and future directions

Hoeffe

Desjardins

Fischer

et al. 2016

CJEM

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“…However, complete sonographic assessment of the affected children requires initial FAST investigation combined with follow-up investigations [26][27][28].…”

Section: Discussionmentioning

confidence: 99%

Is sonography reliable for the diagnosis of pediatric blunt abdominal trauma?

Retzlaff¹,

Hirsch

Till

et al. 2010

Journal of Pediatric Surgery

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“…Although point-of-care ultrasound is relatively new to pediatrics, it is growing rapidly in subspecialty fields such as pediatric emergency medicine, critical care, and neonatology. [1][2][3] The use of point-of-care ultrasound to guide invasive procedures, quickly focus the evaluation of critically ill patients, and reduce exposure to ionizing radiation are some of the factors driving the adoption of bedside ultrasound by pediatric physicians caring for the sickest and most complex pediatric patients.…”

mentioning

confidence: 99%

Bedside Ultrasound in Pediatric Practice

Vieira

Bachur

2014

Pediatrics

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. Overnight shift in the pediatric emergency department. In 1 room, the fellow is attempting to place a central venous catheter in a 5-year-old boy with presumed septic shock but has been unable to locate the femoral vein with her finder needle. In the next room lies a 7-year-old trauma patient. He is tachycardic with poor perfusion and abrasions on his chest. The team calls for a portable chest radiograph and begins a secondary survey. The resident taps your shoulder. "Can I present a patient?" He describes a 15-year-old girl with lupus complaining of chest pain who is ill appearing, tachycardic, and short of breath. "I ordered labs and chest radiograph."July 1, 2012. Overnight shift in the pediatric emergency department. In 1 room, the fellow is attempting to place a central venous catheter in a 5-year-old boy with presumed septic shock. Using bedside ultrasound, she makes adjustments with her finder needle until she sees it enter the femoral vein. In the next room lies a 7-year-old trauma patient. He is tachycardic with poor perfusion and abrasions on his chest. The team performs an extended focused assessment with sonography for trauma examination, which reveals free fluid in Morison' s pouch and no pneumothorax. A computed tomography scan of the abdomen is prioritized, and type O negative blood is ordered. The resident taps your shoulder. "Can I present a patient?" He describes a 15-year-old girl with lupus complaining of chest pain who is ill appearing, tachycardic, and short of breath. "I did a bedside ultrasound, and she has a pericardial effusion."In 2002, many pediatricians, including the authors, viewed point-of-care ultrasound as a tool used primarily by "general" emergency physicians, cardiologists, and obstetricians. The relevance to our pediatric patients seemed uncertain. Ten years later, the advantages that pointof-care ultrasound offers to those caring for ill, injured, and diagnostically challenging children are difficult to ignore. Although point-of-care ultrasound is relatively new to pediatrics, it is growing rapidly in subspecialty fields such as pediatric emergency medicine, critical care, and neonatology.1-3 The use of point-of-care ultrasound to guide invasive procedures, quickly focus the evaluation of critically ill patients, and reduce exposure to ionizing radiation are some of the factors driving the adoption of bedside ultrasound by pediatric physicians caring for the sickest and most complex pediatric patients.Still, pediatricians who finished training more than a decade ago likely did not receive instruction in point-of-care ultrasound because the relevance to general pediatric patients had not yet been demonstrated. What does point-of-care ultrasound afford pediatrics today? We believe AUTHORS:

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Bedside ultrasound in the pediatric emergency department

Cited by 25 publications

References 73 publications

Emergency point-of-care ultrasound in Canadian pediatric emergency fellowship programs: current integration and future directions

Emergency point-of-care ultrasound in Canadian pediatric emergency fellowship programs: current integration and future directions

Is sonography reliable for the diagnosis of pediatric blunt abdominal trauma?

Bedside Ultrasound in Pediatric Practice

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