搜索结果：POCUS

Existing literature indicates that patients respond positively to point-of-care ultrasound (POCUS) across various clinical settings. However, limited research explores how patient-families perceive its use in pediatric emergency department (ED) care. Our study aims to evaluate POCUS's impact on patient experience, stress, and anxiety in the pediatric ED. We conducted a randomized study (1:1) of pediatric patients (&#x2264;&#x2009;17&#x2009;years) presenting with a clinical indication for POCUS (lung, FAST, cardiac, or soft tissue applications). Patients were assigned to either a POCUS or non-POCUS group, excluding those who were unstable or had prior POCUS evaluations. Patient-families completed pre- and post-surveys (5-point Likert scale) at triage and ED disposition. Demographic data were obtained from the electronic medical record. Statistical analyses included Chi-Square, Fisher's Exact, Wilcoxon, and sign tests (&#x3b1;&#x2009;=&#x2009;0.05) to compare group responses and assess for changes in responses over time. A total of 200 patient-families were enrolled. The cohort was primarily English-speaking, non-Hispanic White males, with an average age of 5.16&#x2009;years (SEM &#xb1;0.37). Common chief complaints included cough (34%), fever (15%), abdominal pain (14%), and shortness of breath (13%). No significant differences were observed in patient experience or ED length of stay. Sign tests indicated significant reductions in stress and anxiety within both groups from pre- to post-survey assessments [Anxiety: p&#x2009;<&#x2009;0.0001 (POCUS), p&#x2009;=&#x2009;0.0003 (non-POCUS); Stress: p&#x2009;<&#x2009;0.0001 (POCUS), p&#x2009;<&#x2009;0.0001 (non-POCUS)]. POCUS patient-families reported a significantly greater perceived importance of imaging and stated that POCUS directly alleviated their stress and anxiety. The primary outcome, magnitude of change in stress and anxiety, demonstrated significant reductions in both POCUS and non-POCUS groups. Despite similar findings within each group, families receiving POCUS reported greater perceived importance of imaging and strong support for its use, highlighting its potential to enhance patient-centered care and support further research into its optimal implementation in pediatric emergency care.

Point-of-care ultrasound (POCUS) is a valuable clinical skill that improves clinical care but requires substantial training. Validated assessment tools provide empirical evidence regarding trainee performance while also informing program-level evaluation. We developed two POCUS-specific stations for objective structured clinical examinations (OSCEs) to assess skill acquisition and inform best practices in undergraduate medical education. A multidisciplinary group of POCUS educators identified two POCUS applications (pleural effusion and abdominal free fluid) well suited for the undergraduate level. A modified Delphi approach was used to develop POCUS-application-specific skill checklists and global rating scale. Two medical programs piloted the stations to inform reliability. Across two sites, 46 and 41 students participated in the pleural effusion and abdominal free fluid stations respectively. Checklists showed high internal reliability, with Cronbach's alpha of 0.85 (95% CI 0.71-0.93) for the pleural effusion station and 0.87 (95% CI 0.74-0.95) for the abdominal free fluid station. Krippendorff's alpha, a measure of inter-rater reliability, was also equally strong at 0.85 (95% CI 0.43-0.94) and 0.83 (95% CI 0.50-0.94) respectively. Both POCUS OSCE stations demonstrated good internal and inter-rater reliability. Deployment of these OSCE stations at programs with integrated POCUS curricula may help refine programming and training expectations. L'&#xe9;chographie au point d'intervention (POCUS) est une comp&#xe9;tence clinique pr&#xe9;cieuse qui am&#xe9;liore les soins cliniques, mais qui n&#xe9;cessite une formation approfondie. Des outils d'&#xe9;valuation valid&#xe9;s fournissent des preuves empiriques concernant les performances des m&#xe9;decins r&#xe9;sidents tout en &#xe9;clairant l'&#xe9;valuation au niveau du programme. Nous avons d&#xe9;velopp&#xe9; deux stations propres &#xe0; POCUS pour les examens cliniques objectifs structur&#xe9;s (ECOS) afin d'&#xe9;valuer l'acquisition des comp&#xe9;tences et d'&#xe9;clairer les meilleures pratiques dans l'enseignement m&#xe9;dical de premier cycle. Un groupe multidisciplinaire d'&#xe9;ducateurs POCUS a identifi&#xe9; deux applications POCUS (&#xe9;panchement pleural et liquide libre abdominal) bien adapt&#xe9;es au niveau de premier cycle. Une approche Delphi modifi&#xe9;e a &#xe9;t&#xe9; utilis&#xe9;e pour d&#xe9;velopper des listes de contr&#xf4;le des comp&#xe9;tences sp&#xe9;cifiques &#xe0; l'application POCUS et une &#xe9;chelle d'&#xe9;valuation globale. Deux programmes m&#xe9;dicaux ont test&#xe9; les stations afin d'en v&#xe9;rifier la fiabilit&#xe9;. Sur les deux sites, 46 et 41 &#xe9;tudiants ont respectivement particip&#xe9; aux stations consacr&#xe9;es &#xe0; l'&#xe9;panchement pleural et au liquide libre abdominal. Les listes de contr&#xf4;le ont montr&#xe9; une fiabilit&#xe9; interne &#xe9;lev&#xe9;e, avec un coefficient alpha de Cronbach de 0,85 (IC &#xe0; 95 % : 0,71-0,93) pour la station consacr&#xe9;e &#xe0; l'&#xe9;panchement pleural et de 0,87 (IC &#xe0; 95 % : 0,74-0,95) pour la station consacr&#xe9;e au liquide libre abdominal. Le coefficient alpha de Krippendorff, qui mesure la fiabilit&#xe9; inter-&#xe9;valuateurs, &#xe9;tait &#xe9;galement &#xe9;lev&#xe9;, avec respectivement 0,85 (IC &#xe0; 95 % : 0,43-0,94) et 0,83 (IC &#xe0; 95 % : 0,50-0,94). Les deux stations POCUS ECOS ont d&#xe9;montr&#xe9; une bonne fiabilit&#xe9; interne et inter-&#xe9;valuateurs. Le d&#xe9;ploiement de ces stations ECOS dans des programmes int&#xe9;grant des cursus POCUS pourrait contribuer &#xe0; affiner les attentes en mati&#xe8;re de programmation et de formation.

Point-of-care ultrasound (PoCUS) is increasingly integrated into acute care for its diagnostic efficiency and accessibility. While prior studies associate PoCUS use with higher patient satisfaction, little is known about how patients themselves experience it as part of their care. To explore how patients experience PoCUS during acute care encounters and how it shapes their overall perception of care. Qualitative study using semi-structured interviews and reflexive thematic analysis within a constructivist paradigm. Eighteen adult patients who underwent PoCUS during emergency department or inpatient general internal medicine assessments at a tertiary care academic hospital in Ottawa, Canada. Participants were recruited and interviewed at the bedside shortly after receiving PoCUS examinations. Transcripts were inductively coded and analyzed using Braun and Clarke's six-phase framework for reflexive thematic analysis. Three interrelated themes captured how patients experienced PoCUS. First, PoCUS enhanced both emotional reassurance and physical convenience through real-time feedback and avoidance of transport to diagnostic areas. Second, patients perceived PoCUS as integrated within holistic, patient-centered care, where their impressions of PoCUS were intertwined with their impressions of the care they received overall. Third, patients' largely positive experiences were grounded in trust in their physicians despite and in the midst of limited technical understanding of PoCUS. Overall, patients had positive experience with PoCUS integration. With little technical knowledge of PoCUS, patients' positive views were shaped by trust and interaction with physicians. While supporting existing literature, our findings stress the need for clear communication and scope awareness. As PoCUS use increases in prevalence, it should be seen as both a diagnostic tool and a contributor to patient-centered care.

This study aimed to explore Emergency Medical Services (EMS) providers' perceptions of prehospital Point-of-Care Ultrasound (POCUS), including perceived usefulness, facilitators, and barriers to its implementing in Jordanian prehospital settings. A multicenter cross-sectional study was conducted among EMS providers using a structured questionnaire. Attitudes were measured using a four-point Likert scale, while facilitators and barriers were assessed with dichotomous (yes/no) responses. A total attitude score was calculated by summing Likert-scale responses. Descriptive statistics were used to summarize responses and inferential analyses (independent-samples t-tests and ANOVA) were conducted to examine group differences. Internal consistency was evaluated using Cronbach's alpha and Kuder-Richardson Formula 20 (KR-20). A total of 621 participants were included in the study. The majority were males (78.3%), with a mean age of 29.5&#x2009;&#xb1;&#x2009;4.4 years and EMS experience of 9.7&#x2009;&#xb1;&#x2009;4.6 years. Only 23.3% reported previous POCUS training. Overall, participants demonstrated a net positive attitude toward POCUS (mean score&#x2009;=&#x2009;27.9&#x2009;&#xb1;&#x2009;5.4; Cronbach's &#x3b1;&#x2009;=&#x2009;0.836), though a substantial proportion (50.0%) expressed uncertainty regarding an absolute POCUS safety claim, a pattern that was independent of prior training status. A proportion of 79.6% expressed willingness to learn about POCUS, 79.4% agreed that POCUS supports standard assessment and 78.8% agreed that POCUS provides additional information for decision-making. The three main reported motivators were training availability (83.1%), direct supervision during use (81.8%) and institutional support (79.4%). The three main barriers were lack of time (76.7%), unavailability of training programs (74.2%) and lack of POCUS experts (73.4%). Participants with prior POCUS training had significantly higher attitude scores (p = .001). EMS providers in Jordan demonstrated a net positive attitude toward POCUS as a potentially useful adjunct to prehospital care, though a substantial proportion expressed safety-related uncertainty, consistent with the absence of routine operational exposure to the technology. Adoption of POCUS remains constrained by structural and training-related barriers. These findings reflect perceived value rather than demonstrated clinical effectiveness. Addressing gaps in training, supervision, competency-based credentialing and imaging governance may support future integration, but further research is required to evaluate clinical and operational outcomes.

Point-of-care ultrasound (POCUS) has become an essential diagnostic tool in clinical practice, particularly in the emergency room. While POCUS has recently been incorporated into medical school curricula, the introduction of specialized cardiac POCUS (cPOCUS) curricula remains limited. This study aimed to develop, implement, and evaluate a cPOCUS module for medical students. A single group pre/post educational intervention study was conducted at the University of Sharjah, United Arab Emirates, in November 2025. Participants included year 4 medical students. Students' perceptions, prior exposure, and learning needs regarding point-of-care ultrasound were assessed. A structured 5-hour cPOCUS teaching module was implemented, including theoretical and hands-on sessions. Outcomes were assessed using multiple-choice questions (MCQs) and a practical skills checklist. While all students expressed a motivation to learn POCUS and 90% considered it essential for emergency care, only 17% had prior exposure to POCUS training. Following the module, the median knowledge score increased from 4 (IQR: 2-8) to 8 (IQR: 6.75-9) (p <&#x202f;0.05). The practical skills assessment showed "very good" performance in 94% of participants. Almost all students (95%) felt confident performing cPOCUS. This module enhanced theoretical understanding and practical skills, fostering a high level of confidence in imaging in the short term. These findings support the integration of cPOCUS in undergraduate medical school curricula.

Point-of-Care Ultrasound (POCUS) has an expanding role in clinical practice and medical education. However, evidence for the impact of clinician-led POCUS training on anatomy comprehension and student comfort with POCUS remains limited. We aimed to determine whether clinician-led POCUS training in pre-clinical medical school curricula improved students' performance on anatomy assessments and confidence using ultrasound. This staggered cohort study was granted exempt status by the VCOM IRB (# 2023-052). Pre-clinical students were randomized into 2 groups. Both groups underwent a baseline test and an "Introduction to POCUS" session, followed by staggered sessions on abdominal, shoulder, and cardiac POCUS including didactic and hands-on components. After each of these staggered sessions, quizzes compared the knowledge of students who received POCUS against those who had not. Finally, the students repeated the baseline test and subjective evaluations of the use of POCUS. Multiple "free scan" workshops were available during the study. Pearson's chi-square test was used to compare the knowledge assessments, and Wilcoxon Rank Sum Test was used to compare ordinal scores. Between-group differences in percent correct were statistically significant in 2 questions (curved probe indication and probe marker orientation). The Total Score results achieved statistical significance (Pre: 4.41 &#xb1; 1.66, post: 6.41 &#xb1; 1.97, p = 0.0005). Q10a, an ordinal question that gauged participants' comfort in utilizing ultrasounds in clinical practice, also achieved statistical significance (Pre: 2.31 &#xb1; 1.20, post: 3.69 &#xb1; 0.87, p = 0.0018). Integrating clinician-led POCUS workshops into pre-clinical curricula was associated with greater comfort using ultrasound in clinical settings and a trend toward improved anatomy knowledge even though gains were inconsistent. These findings support earlier POCUS exposure in pre-clinical education; longer studies and larger cohorts are needed to assess the durability of learning and transfer of skills to clinical settings.

Point-of-care ultrasound (POCUS) is increasingly used across pediatric subspecialties. However, training opportunities in pediatric POCUS remain limited, and few studies have detailed the curriculum development process, making it challenging for other institutions to adopt. This paper describes the iterative development of a pediatric POCUS training curriculum in a setting without prior POCUS experience. We employed Kern's 6-step approach to curriculum development to design a pediatric POCUS training program. The educational intervention was grounded in experiential learning and deliberate practice. A mixed-methods analysis of participant feedback was used for the iterative development of the course curriculum. Predictors of successful certification were analyzed using multiple logistic regression. Between 2018 and 2023, 136 physicians participated in nine course iterations, providing 347 survey responses that informed course development. Overall satisfaction was high, but learners expressed a need for more supervised hands-on scanning with real patients than originally provided. The curriculum reached its final format after three iterations. Most in-person contact time was dedicated to supervised hands-on scanning. The inclusion of the online learning platform ImageSim enabled learners to develop image interpretation skills asynchronously. Learners participating in the final curriculum format and those who saved most scans initially were most likely to get certified. Costs were primarily associated with trainer salaries, which were covered by participation fees. Even in the absence of preexisting POCUS experience, our iterative curriculum development process led to the creation of a successful pediatric POCUS course in accordance with participants' needs. This study can serve as a guide for other institutions considering the development of a pediatric POCUS training program.

Renal colic is a common emergency department (ED) presentation, and imaging practices vary despite increasing use of renal point-of-care ultrasound (rPOCUS). To evaluate the association between rPOCUS findings and Computed tomography (CT) utilization, ED length of stay (LOS), and downstream urologic interventions in patients with suspected renal colic. We conducted a retrospective cohort study of adults undergoing rPOCUS for suspected renal colic from January 2020 through January 2022. Standardized chart abstraction with double review of a subset captured prespecified clinical and imaging variables. Comparative analyses and regression models assessed predictors of CT utilization, stone detection, urologic intervention timing, and ED LOS. Among 188 patients, 89 (47%) had hydronephrosis on rPOCUS. CT was obtained in 108 (57%) and was notably more common in patients with hydronephrosis on rPOCUS (72% vs. 44%; adjusted OR: 2.63, 95% CI: 1.29-5.46). Hydronephrosis predicted ureteral stone presence on CT (74% vs. 30%; OR: 6.71) and urologic intervention within 24 hours (26% vs. 6%; OR: 5.40). Clinically significant alternative diagnoses were uncommon (1.6%) and occurred only in patients without hydronephrosis. Mean LOS did not differ by hydronephrosis status (269 vs. 273 minutes; p = 0.81), but LOS was longer when CT was performed (p < 0.01). In multivariable analysis, CT utilization and abdominal tenderness were associated with longer LOS, whereas hydronephrosis was not. Hydronephrosis on rPOCUS was associated with stone disease and early urologic intervention but not shorter ED LOS. CT utilization was higher in patients with hydronephrosis and remained the primary factor associated with prolonged ED throughput. These findings reflect contemporary imaging patterns and suggest that the operational benefits of rPOCUS may be limited when CT is obtained irrespective of ultrasound findings.

Background: Point-of-care ultrasound (POCUS) is an increasingly valuable tool in general practice/family medicine (GP/FM). This position paper from the European Academy of Teachers in General Practice/Family Medicine outlines recommendations for integrating POCUS education across the continuum of training: undergraduate, specialty, and continuing medical education. Recommendations: POCUS should complement, not replace, the clinical examination. Key priorities include GP/FM-targeted curriculum development, early exposure during basic medical education, mandatory residency training, context-sensitive continuing professional development, train-the-trainer programmes, and GP/FM-led implementation. Discussion: Integrating POCUS teaching across all stages of GP/FM education may support effective and sustainable adoption in primary care. Educational strategies should be adapted to local contexts and healthcare systems while maintaining a focus on clinically relevant and evidence-informed use. Conclusion: EURACT recommends the longitudinal integration of POCUS education throughout GP/FM training and professional development. These principles aim to guide the effective, sustainable, and context-sensitive implementation of POCUS in primary care. POCUS teaching in GP/FM should be integrated across basic medical education, specialty training, and continuing professional development.GP/FM targeted curriculum development, early exposure, and training during residency are essential for effective adoption.Context-sensitive continuing education and train-the-trainer programs support sustainable implementation.

Limited access to specialist expertise in point-of-care ultrasound (POCUS) in rural areas may adversely affect patient care and healthcare systems by increasing reliance on costly imaging modalities (e.g., computed tomography or magnetic resonance imaging [MRI]) and unnecessary patient transfers to specialized centers. Telemedical support represents a promising strategy to address this gap. In this block-randomized controlled trial with allocation concealment, a total of 358 patients requiring ultrasound were assigned to two POCUS groups: 184 patients received standard POCUS without teleconsultation, and 174 received POCUS supported by remote experts via telemedicine. All examinations were performed by the most experienced available local providers. Standardized post-examination questionnaires were administered to assess perceptions of the diagnostic process. No statistically significant differences were observed between telemedicine-assisted POCUS and standard POCUS. The study also provides insights into the feasibility and diagnostic performance of teleconsultation-supported ultrasound in real-world clinical settings. MRI utilization was significantly lower in the teleconsultation group (P=0.002). Telemedicine-assisted POCUS demonstrated acceptability and comparable care outcomes relative to standard practice. Its potential to reduce reliance on high-cost diagnostic modalities supports its relevance as a scalable and efficient care model.

Introduction Point-of-care ultrasound (POCUS) has a well-established role in acute medical care and is particularly valuable in conflict zones where access to advanced imaging is limited. To aid Ukrainian healthcare providers, POCUS courses were implemented, and doctors received education and ultrasound probes to use on the frontlines. The objectives of this study were to evaluate the use of POCUS by novice users in conflict-related medical environments, using the war in Ukraine as a case study. We sought to identify how and where medical personnel use ultrasound after an introductory POCUS course, and what barriers to use exist. Methods This was a cross-sectional survey of former participants in two-day POCUS training courses organized by Razom for Ukraine and the Christian Medical Association of Ukraine between January 2023 and September 2024. Applications taught included Focused Assessment with Sonography for Trauma (FAST), cardiac, lung, deep vein thrombosis (DVT), soft tissue, renal, hepatobiliary, soft tissue, nerve blocks, vascular access, musculoskeletal, and ocular. All course participants were medical personnel managing soldiers injured in battle. A link to the survey was distributed by Telegram, a messaging platform. Participation was voluntary and anonymous. This research was deemed to be exempt by the Institutional Review Board (IRB). Results The survey was sent to 352 participants. A total of 40% (140/352) of participants responded, of which 87% (122/140) were doctors. Participants worked in stabilization points (56%, 78/140), in military hospitals (31%, 43/140), and in medical transport (14%, 19/140). A total of 64% (89/140) used POCUS at least once a day. The most commonly used applications were FAST (89%, 124/140), pneumothorax (72%, 101/140), vascular access (62%, 87/140), soft tissue (54%, 75/140), and nerve blocks (44%, 62/140). The most common educational barriers to use were image interpretation (47%, 66/140) and image acquisition (31%, 44/140). The most common technological problems were damage to the probe or cord (36%, 50/140), a short battery lifespan (32%, 45/140), and not having access to a machine (26%, 36/140). Conclusions After a brief training, novice users regularly used POCUS in the care of wounded soldiers in Ukraine. FAST, pneumothorax, vascular access, soft tissue, and nerve blocks were the most frequently used applications. Future efforts should focus on additional education on image interpretation and acquisition, and on procurement of more ultrasound machines.

Air medical and critical care transport teams often treat severely injured or critically ill patients when imaging, laboratory testing, and specialist support are limited. Point-of-care ultrasound (POCUS) may support early recognition of reversible conditions, but its value depends on strict indication selection, operator competence, and interpretation rules that prevent false reassurance. This structured narrative review summarizes evidence and practical considerations for transport POCUS in trauma and critical care retrieval. The review is organized around a safety-gated framework and groups evidence by clinical use: extended FAST (eFAST) and lung ultrasound, shock assessment, cardiac arrest POCUS, ultrasound-guided procedures, workflow integration, governance, tele-mentoring, and research priorities. Transport POCUS is most useful when it confirms a limited set of urgent, actionable findings. eFAST and thoracic ultrasound generally show high specificity but only moderate sensitivity; therefore, a clear positive finding may trigger action, whereas a negative or technically limited scan should not justify down-triage. Representative studies suggest that prehospital POCUS can influence care processes: one randomized multicenter trial reported that prehospital FAST reduced the median time to admission by 13&#x202f;min and the median time to operative treatment by 15&#x202f;min, while a prospective HEMS cohort found that POCUS was used in 34.5% of patients and had therapeutic consequences in 40.7%. However, evidence for mortality, complication reduction, and long-term patient-centered outcomes remains limited. Transport POCUS should function as a focused decision-support tool, not as a substitute for definitive imaging. Safe implementation requires clear scope, time caps, "indeterminate = not reassuring" rules, structured documentation, competency-based training, discrepancy review, and quality assurance. Future studies should move beyond feasibility and time-to-care endpoints to evaluate safety, false-negative harms, complications, and patient-centered outcomes.

Point-of-care ultrasound (POCUS) training has been adopted in some undergraduate medical education programs globally, though it remains uncommon in low-income settings. In 2022, the University of Global Health Equity in Rwanda established an integrated, longitudinal POCUS curriculum spanning preclinical through clinical training, designed to produce general practitioners competent in POCUS examinations most needed in district hospital settings. We describe this curriculum and report educational outcomes from multiple student cohorts. We developed competency-based learning objectives mapped onto the existing 6.5-year curriculum, incorporating didactic sessions, hands-on training with standardized patients, clinical application during clerkships, and online learning resources. Students used handheld ultrasound devices across clinical sites. We assessed the curriculum through student evaluations, self-reported confidence measures, knowledge assessments, and a final certification examination consisting of a 30-item multiple choice test and 3-station objective structured clinical examination. Knowledge scores improved significantly following educational sessions, from 68.8% to 90.0% after the introductory session (p&#x2009;<&#x2009;0.001) and from 69.3% to 93.1% after intensive training (p&#x2009;<&#x2009;0.001), with very large effect sizes on confidence measures (Cohen's d 1.39-2.38). Longitudinal assessment of one cohort demonstrated significant improvements in overall performing confidence (d&#x2009;=&#x2009;1.11, p&#x2009;<&#x2009;0.001) and interpreting confidence (d&#x2009;=&#x2009;0.93, p&#x2009;<&#x2009;0.001) across clinical training, with largest gains in obstetric (d&#x2009;=&#x2009;1.70) and renal/bladder (d&#x2009;=&#x2009;1.03) examinations. A subsequent cohort receiving the complete preclinical curriculum demonstrated significantly higher confidence than students who received clinical-only training at a similar training point (performing: d&#x2009;=&#x2009;0.55, p&#x2009;=&#x2009;0.022; interpreting: d&#x2009;=&#x2009;0.47, p&#x2009;=&#x2009;0.048), with 89% agreeing preclinical training facilitated clinical learning. During internship, 68% used POCUS clinically, with all finding it helpful for patient care. Twenty-seven of 30 graduating students took the final examination and 96% passed. Primary barriers were limited supervision, time constraints, and equipment access at district hospitals. An integrated, longitudinal POCUS curriculum is feasible in a low-income setting and produces graduates with strong foundational knowledge and clinical confidence. Earlier curriculum initiation may enhance preparation for clinical practice. Future efforts will focus on faculty development and improving POCUS infrastructure at clinical sites.