African journal of emergency medicine : Revue africaine de la medecine d'urgence · 2020
A descriptive study of the use of cardiac point of care ultrasound (PoCUS) in public emergency centres in Cape Town.
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Ganas Ushira, Malan Jacques J, Bruijns Stevan R
Аннотация
INTRODUCTION: The indications for cardiac point of care ultrasound (PoCUS) vary somewhat in different parts of the world, and training programs may also differ. We set out to describe the self-reported cardiac PoCUS indications and imaging windows used at a selection of secondary-level, public hospital emergency centres in Cape Town.
METHODS: A descriptive study with prospective data collected from emergency centres of Mitchells Plain District, Victoria and New Somerset Hospitals in Cape Town were used. Data were collected over a three-month period by providers who have completed a basic emergency ultrasound course, using a purpose-designed data collection tool for all cardiac PoCUS scans.
RESULTS: Fifteen PoCUS providers recorded 267 data entries over the three-month study period; there were 17 exclusions, leaving 250 entries for analysis. The most common indication for performing cardiac PoCUS was electrocardiogram abnormalities, 27% (n = 112); dyspnoea, 25% (n = 102); chest pain, 16% (n = 65); cardiomegaly on chest x-ray, 12% (n = 51); new murmur, 6% (n = 23); and chest trauma, 5% (n = 22). Other indications made up the remaining 10% (n = 40). Parasternal long and short axis were the predominantly used views.
CONCLUSION: Cardiac PoCUS is used for a wide range of indications beyond the recommended training guidelines. Some indications may be more useful in low- to middle-income settings. Further research needs to be done to ascertain the extent of the use of cardiac PoCUS, and possibly the need for a more comprehensive training program with adequate training in these clinical conditions, to ensure safe practice.
METHODS: A descriptive study with prospective data collected from emergency centres of Mitchells Plain District, Victoria and New Somerset Hospitals in Cape Town were used. Data were collected over a three-month period by providers who have completed a basic emergency ultrasound course, using a purpose-designed data collection tool for all cardiac PoCUS scans.
RESULTS: Fifteen PoCUS providers recorded 267 data entries over the three-month study period; there were 17 exclusions, leaving 250 entries for analysis. The most common indication for performing cardiac PoCUS was electrocardiogram abnormalities, 27% (n = 112); dyspnoea, 25% (n = 102); chest pain, 16% (n = 65); cardiomegaly on chest x-ray, 12% (n = 51); new murmur, 6% (n = 23); and chest trauma, 5% (n = 22). Other indications made up the remaining 10% (n = 40). Parasternal long and short axis were the predominantly used views.
CONCLUSION: Cardiac PoCUS is used for a wide range of indications beyond the recommended training guidelines. Some indications may be more useful in low- to middle-income settings. Further research needs to be done to ascertain the extent of the use of cardiac PoCUS, and possibly the need for a more comprehensive training program with adequate training in these clinical conditions, to ensure safe practice.