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.