Use of Emergency Ultrasound in Arizona Community Emergency Departments
Use of Emergency Ultrasound in Arizona Community Emergency Departments
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DOI：
10.7863/ultra.16.05064
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发表时间：
2017-05-01
影响因子：
2.3
通讯作者：
Adhikari, Srikar
中科院分区：
文献类型：
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作者：
Amini, Richard;Wyman, Michael T.;Adhikari, Srikar
目的尽管在各级医疗培训中对床旁超声（US）的教育有所增加，但学术和非学术急诊科（艾德）设置之间存在使用差距。本研究的目的是评估目前的做法和潜在的障碍，使用点的护理美国在非学术ED在整个亚利桑那州。一份在线问卷以电子方式发送给亚利桑那州所有非学术ED。该调查包括人口统计学，目前的实践模式，政策，部门间协议，以及对使用点的护理US.ResultsSeventy的非学术ED的看法的问题被确定为包括在我们的研究，和58个ED完成了调查，这代表了83%的响应率。78%（95%置信区间[CI]，67%-89%）执行或解释用于患者护理的床旁超声检查。受访者报告的3种最常见的床旁超声应用是创伤超声检查的重点评估、心脏超声检查和管路放置，床旁超声检查的费用为36%（95% CI，22%-50%）。在75%（95% CI，62%-88%）的ED中，没有人专门负责审查床旁超声检查以保证质量，在50%（95% CI，35%-65%）的ED中，没有存档图像的机制。百分之八十三（95%CI，72%-94%）的ED认为，他们的团体将受益于美国大学的急诊医师临床超声认证Program.ConclusionsUltrasound equipment几乎所有的非学术ED在亚利桑那州。然而，似乎大多数供应商缺乏美国的培训，认证，质量保证和报销机制。
ObjectivesDespite the increased educational exposure to point-of-care ultrasound (US) at all levels of medical training, there are utilization gaps between academic and nonacademic emergency department (ED) settings. The purpose of this study was to assess the current practices and potential barriers to the use of point-of-care US in nonacademic EDs throughout the state of Arizona.MethodsWe conducted a cross-sectional study. An online questionnaire was electronically sent to all nonacademic EDs in Arizona. The survey consisted of questions regarding demographics, current practice patterns, policies, interdepartmental agreements, and perceptions regarding the use of point-of-care US.ResultsSeventy nonacademic EDs were identified for inclusion in our study, and 58 EDs completed the survey, which represented an 83% response rate. Seventy-eight percent (95% confidence interval [CI], 67%-89%) perform or interpret point-of-care US examinations for patient care. The 3 most common applications of point-of-care US reported by respondents were focused assessment with sonography for trauma, cardiac US examinations, and line placement, and 36% (95% CI, 22%-50%) bill for point-of-care US examinations. At 75% (95% CI, 62%-88%) of EDs, no one is specifically responsible for reviewing point-of-care US examinations for quality assurance, and at 50% (95% CI, 35%-65%), no mechanism exists to archive images. Eighty-three percent (95% CI, 72%-94%) of EDs think that their groups will benefit from the American College of Emergency Physicians Clinical Ultrasound Accreditation Program.ConclusionsUltrasound equipment is available in nearly all nonacademic EDs in Arizona. However, it appears that most providers lack US training, credentialing, quality assurance, and reimbursement mechanisms.