Use of point-of-care ultrasound in Connecticut emergency departments

Background: Point-of-care ultrasound (PoC US) is now taught and used in nearly all academic emergency departments (EDs), but prior surveys have shown that adoption in the community ED setting is much lower.

Objective: Our aim was to characterize the current practice of emergency physician (EP)-performed PoC US in Connecticut.

Methods: We conducted a 20-question online survey of all ED directors in Connecticut to determine how PoC US is utilized. The questions addressed ED demographics, ownership of ultrasound (US) equipment, frequency of PoC US performance in general and by examination type, credentialing patterns, quality assurance methods, and billing patterns.

Results: The response rate was 83% (25 of 30). Almost all (96%) respondent EDs owned at least one US machine, and 24% used US regularly for diverse applications according to 2008 American College of Emergency Physicians (ACEP) guidelines. PoC US was most commonly used for Focused Assessment with Sonography in Trauma examinations, procedural guidance, and assessing the aorta for an abdominal aortic aneurysm. Although 64% reported hospital ultrasonography privileges, 40% did not keep any record of PoC US performed in the ED. More than half (56%) required an over-read by radiology, and 36% required an over-read by another EP (e.g., ED Ultrasound Director). Only 8% of EDs billed for PoC US.

Conclusions: Most Connecticut EDs own an US machine and have hospital privileges for PoC US. However, a minority use or bill for PoC US regularly for diffuse applications, and most do not have a quality assurance program as described by ACEP guidelines.