Impact of Emergency Medicine Point-of-Care Ultrasound on Radiology Ultrasound Volumes in a Single Pediatric Emergency Department

Radiologists should support non-radiologist point-of-care ultrasonography in children: a case for involvement and collaboration

“…In the USA, Conlon and colleagues [ 14 ] initiated a truly collaborative training and quality-assurance effort between the paediatric radiology and paediatric emergency medicine departments at a large children’s hospital that did not impose accreditation by radiologists. Kaplan et al [ 15 ] showed that in fact radiologist-performed US increased or remained stable during the introduction and growth of emergency medicine POCUS because of a complementary role, rather than substandard US at the point of care. One reasonable explanation is that clinicians use POCUS as a screening tool but defer to radiologists for full characterization of findings and more time-consuming details that escape their area of competence.…”

Point-of-care ultrasonography: Downstream utilization of and diagnostic (dis)agreements with additional cross-sectional imaging

“…Another study by Kaplan et al [8] investigated if and how volumes of radiology US examinations ordered by emergency medicine changed as POCUS grew at their pediatric hospital in the United States between 2011 and 2017. They reported that emergency medicine POCUS growth was accompanied by steady or increasing volumes of emergency medicine ordered radiology US examinations [8]. They also reported that skin and soft tissue infection US, an examination performed diagnostically by both radiology and emergency medicine, showed stable or increased volumes of radiology US examinations during growth in POCUS [8].…”

“…They reported that emergency medicine POCUS growth was accompanied by steady or increasing volumes of emergency medicine ordered radiology US examinations [8]. They also reported that skin and soft tissue infection US, an examination performed diagnostically by both radiology and emergency medicine, showed stable or increased volumes of radiology US examinations during growth in POCUS [8]. Kaplan et al [8] concluded that radiology US and POCUS are complementary rather than competing practices, and that POCUS has not replaced radiology US in an area of overlapping service.…”

“…They also reported that skin and soft tissue infection US, an examination performed diagnostically by both radiology and emergency medicine, showed stable or increased volumes of radiology US examinations during growth in POCUS [8]. Kaplan et al [8] concluded that radiology US and POCUS are complementary rather than competing practices, and that POCUS has not replaced radiology US in an area of overlapping service. It was outside the scope of the present study to assess whether POCUS has affected the US volumes that are performed by our radiology department.…”

“…This may lead to imaging overutilization when clinicians request too many additional cross-sectional imaging examinations to confirm their US interpretations [6]. Although there is some literature on the downstream utilization of imaging after POCUS and on the volumes of US examinations in a radiology department after introduction of POCUS [7][8], there are currently no data on why clinicians request subsequent cross-sectional imaging after POCUS and how often radiologists face diagnostic discrepancies. This information is important to support the value of POCUS, and to identify potential areas for improvement and further research.…”