Do emergency physicians rely on point-of-care ultrasound for clinical decision making without additional confirmatory testing?

PURPOSE: It is unknown if Emergency Physicians (EPs) rely solely on Emergency Medicine performed Point-Of-Care Ultrasound (EM-POCUS) for clinical decision making or if they proceed to subsequent "gold standard" studies for confirmatory diagnosis.

METHODS

After Institutional Review Board approval, an online survey was distributed by the Ohio Chapter of the American College of Emergency Physicians to its members.

RESULTS

The most common EM-POCUS procedures used without confirmatory testing were: determination of cardiac activity during cardiac arrest (81.3%), differentiating cellulitis from abscess (63.2%), central venous catheter placement confirmation (43.2%), pericardial effusion evaluation (41.9%) and focused assessment with sonography for trauma (FAST-37.4%). The responses regarding remaining procedures suggest most physicians do not use EM-POCUS or verify EM-POCUS findings with additional testing. One hundred fifty-five survey responses provided a confidence interval of >90%. Two-thirds (67.7%) of respondents were board-certified EPs with 43.8% in practice for less than 5 years. EM-POCUS examinations were performed at least weekly by 37.4% of respondents; 28.4% performed at least 1 EM-POCUS examination per shift. Nearly half (47.7%) responded they had no concerns regarding use of EM-POCUS.

CONCLUSIONS

This study describes the results of a survey on the use of EM-POCUS for clinical decision making by Ohio EPs. A majority of them continues to rely on gold standard testing for confirmatory diagnosis, in addition to EM-POCUS.