Physicians using ultrasound in Danish emergency departments are mostly summoned specialists

Abstract

BackgroundEmergency ultrasound is a relatively new diagnostic discipline. It is used as an extension of the clinical examination and is ideal in the setting of acute illness. The objective of this study was to investigate how many Emergency Departments (EDs) in Denmark have implemented emergency ultrasound. We also wanted to give an idea of how many and which physicians have adopted ultrasound as a diagnostic tool so far.MethodsThe study was a cross-sectional, descriptive, multicenter survey that included all physician staffed EDs in Denmark. An Internet based questionnaire was distributed by e-mail to all heads of department. Those departments who responded that ultrasound was available in their department were included in the second part of the study where all physicians working in the ED were contacted and asked to complete a second questionnaire.ResultsAll 28 eligible EDs participated in the first part of the study (Response rate: 100 %). 25 EDs (89 %, 95 % CI: 85-93) had ultrasound equipment available. Questionnaires were distributed to 1,872 physicians in these departments and 561 responded (Response rate: 30 %, 95 % CI: 28-32). Overall 257 (46 %, 95 % CI: 42-50) were users of emergency ultrasound and 304 were non-users (54 %, 95 % CI: 50-58). The largest group with 146 respondents (25 %, 95 % CI: 21-29) were anaesthetists with merely consult duty in the ED. When looking exclusively on physicians with on-call duty in the ED, thus excluding anaesthetists, only 146 (35 %, 95 % CI: 30-40) were users of ultrasound while 269 (65 %, 95 % CI: 60-70) were non-users. There was a considerable difference regarding age, level of training, and medical specialty between users and non-users. Users were mainly anaesthetists and attending physicians from other departments. The majority of non-users were young physicians with on call duty in the ED.ConclusionsWe have found that although almost all Danish EDs have ultrasound equipment available, few physicians working in the ED seem to have adopted the tool. Emergency Ultrasound is mainly performed by specialists who are summoned to the ED in case of severe acute illness and not by those physicians who comprise the backbone of the ED around the clock.

Point-of-care ultrasonography in Norwegian out-of-hours primary health care

“…In this study however, we found that male physicians used ultrasound more than their female colleagues. Other studies have also shown this, suggesting that male physicians are more likely to be early adopters of ultrasound [9,17]. Noteworthy, one study found that females felt they required more training compared to males to start using POCUS [18].…”

“…Emergency departments from other countries have reported much higher rates of ultrasound availability [9,10], albeit not directly comparable due to the structural organization of emergency health care in Norway with smaller volume clinics staffed by general practitioners.…”

Feasibility of cardiac output measurements in critically ill patients by medical students

“…Critical care ultrasonography (CCUS) is a deliberately focused examination, aimed at rapidly answering straightforward clinical questions [1]. In the field of emergency and critical care medicine, CCUS is increasingly used to guide interventions in critically ill patients in various settings by experts and novices [2][3][4][5][6][7][8][9][10][11][12][13][14]. The training process required for users to attain competency in CCUS has varied widely between studies, reflecting the diversity in CCUS training between centers.…”

“…Similarly, there is variability among statements from stakeholders regarding the type of training, the required number of hours spent and examinations performed by the trainee to achieve competency in CCUS [15][16][17]. However, besides these disparities, individual physicians struggle with barriers to its use, such as perceived difficulty in obtaining adequate technical skills [13], limitations in training, need (perceived and real), and costs [6,14].…”

Prehospital prognosis is difficult in patients with acute exacerbation of chronic obstructive pulmonary disease

“…One might argue that the inclusion period could be extended further back in time. In recent years, however, the treatment possibilities have expanded within the prehospital medical services [ 36 , 37 ], alongside improved diagnostic capabilities through point of care ultrasound and arterial blood gas analysis [ 38 ]. Therefore, the authors believe that the possible adjustments to create a larger sample size would result in a more heterogeneous patient population.…”