Point-of-Care Ultrasonography by Pediatric Emergency Physicians

Abstract

Point-of-care ultrasonography is increasingly being used to facilitate accurate and timely diagnoses and to guide procedures. It is important for pediatric emergency physicians caring for patients in the emergency department to receive adequate and continued point-of-care ultrasonography training for those indications used in their practice setting. Emergency departments should have credentialing and quality assurance programs. Pediatric emergency medicine fellowships should provide appropriate training to physician trainees. Hospitals should provide privileges to physicians who demonstrate competency in point-of-care ultrasonography. Ongoing research will provide the necessary measures to define the optimal training and competency assessment standards. Requirements for credentialing and hospital privileges will vary and will be specific to individual departments and hospitals. As more physicians are trained and more research is completed, there should be one national standard for credentialing and privileging in point-of-care ultrasonography for pediatric emergency physicians.

Pediatric Emergency Medicine Physicians’ Use of Point‐of‐care Ultrasound and Barriers to Implementation: A Regional Pilot Study

“…PEM practitioners reported having difficulty learning PEM POCUS through informal, self‐directed learning programs due to competing demands for their time. POCUS is a complex and highly technical imaging modality that involves both cognitive and psychomotor skill sets . Accordingly, developing PEM POCUS skills requires substantial formal education programs with dedicated time to learn and practice, as well as the provision of assessment and feedback to the learner.…”

“…More recently, POCUS has gained recognition in the field of pediatric emergency medicine (PEM) as an ideal imaging modality as it is painless, noninvasive, rapid, and dynamic . Most importantly, ultrasound does not use ionizing radiation, which has the potential for harmful effects over the course of a lifetime .…”

“…POCUS has been a testable content specification for the American Board of Pediatrics PEM board examination since 2009, and in 2013 consensus PEM POCUS education guidelines and a model curriculum were published . In 2015, the American Academy of Pediatrics issued a policy statement supporting the use of POCUS by PEM physicians …”

Pediatric emergency medicine point-of-care ultrasound: summary of the evidence

“…For this initial effort, we assembled members of a pediatric emergency POCUS work group, which wrote the recently published POCUS guidelines for pediatric emergency physicians [13, 14]. With collaboration from additional content experts in the field, who had either completed an ultrasound fellowship or specialty training in pediatric emergency POCUS, we sought to create a comprehensive document summarizing the current evidence.…”

Rapid Assessment of the Neonate With Sonography (RANS) Scan

“…The American Academy of Pediatrics acknowledged point-of-care sonography use and training in PEM and recently published the first guidelines for pointof-care sonography implementation by PEM physicians in July 2015. 16,17 While comprehensive expertise in the use of point-of-care sonography requires dedicated training often spanning months, recent studies have demonstrated that the use of an objective-driven ultrasound curriculum can be used to effectively train clinicians in clinically relevant pointof-care sonography in a relatively short time. [18][19][20][21] Currently, published guidelines on accreditation of the neonatologist for targeted neonatal echocardiogram exist, 22,23 but these guidelines are cumbersome Figure 5.…”