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Point of care ultrasound (POCUS) in Canadian neonatal intensive care units (NICUs): where are we?

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Abstract

Objectives

Despite increased evidence that point-of-care ultrasound (POCUS) has the potential to improve patient care in many clinical areas, the extent of use and training in POCUS in Canadian neonatal intensive care units (NICUs) has not been described in the literature. In this study, we aimed to explore the extent to which POCUS is being used and the need for a formal curriculum with defined POCUS competencies in the field of Neonatal-Perinatal Medicine (NPM).

Methods

We sent a cross-sectional electronic survey to all NPM program directors and fellows in Canada. All 13 Canadian NPM programs were invited to participate. Data were analyzed using descriptive statistics and qualitative content analysis.

Results

The response rate was 69% (n = 9) from program directors (PDs) and 29% (n = 25) from NPM fellows. Most respondents indicated regular use of POCUS in clinical practice and ready access to a portable ultrasound machine. The most common use for POCUS was targeted assessment of patent ductus arteriosus (PDA) and persistent pulmonary hypertension (PPHN). Only six PDs reported that POCUS skills are taught to trainees in their centers and only two PDs reported that a structured program existed. Barriers to POCUS structured training include a lack of trained personnel as well as insufficient time in the busy NPM curriculum.

Conclusion

POCUS is widely used in Canadian NICUs. However, a formal curriculum and assessment of competencies in this area of neonatal clinical care are lacking.

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References

  1. Filly RA (1988) Ultrasound: the stethoscope of the future, alas. Radiology 167(2):400

    Article  CAS  PubMed  Google Scholar 

  2. Nguyen J, Amirnovin R, Ramanathan R, Noori S (2016) The state of point-of-care ultrasonography use and training in neonatal-perinatal medicine and pediatric critical care medicine fellowship programs. J Perinatol 36:972–976

    Article  CAS  PubMed  Google Scholar 

  3. Moore CL, Copel JA (2011) Point-of-care ultrasonography. N Engl J Med 364(8):749–757

    Article  CAS  PubMed  Google Scholar 

  4. McGee DC, Gould MK (2003) Preventing complications of central venous catheterization. N Engl J Med 348(12):1123–1133

    Article  PubMed  Google Scholar 

  5. Feller-Kopman D (2006) Ultrasound-guided thoracentesis. CHEST 129(6):1709–1714

    Article  PubMed  Google Scholar 

  6. Woo MY, Frank JR, Lee AC (2014) Point of care ultrasonography adoption in Canada: using diffusion theory and the evaluation tool for ultrasound skills development and education (ETUDE). CJEM 16(5):345–351

    Article  PubMed  Google Scholar 

  7. Steinmetz P, Dobrescu O, Oleskevich S, Lewis J (2016) Bedside ultrasound education in Canadian medical schools: a national survey. CMEJ 7(1):e78–e86

    PubMed  Google Scholar 

  8. Rosenfield D, Kwan C, Fischer J (2015) Point-of-care ultrasound: an emerging technology in Canadian Paediatrics. Paediatr Child Health 20(2):67–68

    Article  PubMed  PubMed Central  Google Scholar 

  9. Bahner DP, Goldman E, Way D, Royall NA, Liu YT (2014) The State of Ultrasound Education in US Medical Schools: results of a National Survey. Acad Med 89:1681–1686

    Article  PubMed  Google Scholar 

  10. Abu-Zidan F (2012) Point of care ultrasound in critically ill patients: where do we stand? J Trauma Shock 5(1):70–71

    Article  Google Scholar 

  11. Marin JR, Lewiss RE, American Academy of Pediatrics, Committee on Pediatric Emergency Medicine et al (2015) Point-of-care ultrasonography by pediatric emergency medicine physicians. Pediatrics 135(4):e1113–e1122

    Article  PubMed  Google Scholar 

  12. Nguyen J (2017) Call for point-of-care ultrasound training regimens in neonatal-perinatal medicine [Letter to editors]. J Pediatrics 185:254

    Article  Google Scholar 

  13. Kurepa D, Zaghloul N, Watkins L, Liu J (2018) Neonatal lung ultrasound exam guidelines. J Perinatol 38(1):11–22

    Article  CAS  PubMed  Google Scholar 

  14. Corsini I, Parri N, Gozzini E, Coviello C et al (2019) Lung ultrasound for the differential diagnosis of respiratory distress in neonates. Neonatology 115(1):77–84

    Article  PubMed  Google Scholar 

  15. Singh Y, Katheria A, Tissot C (2018) Functional Echocardiography in the Neonatal Intensive Care Unit. Indian Pediatr 55(5):417–424

    Article  PubMed  Google Scholar 

  16. Finan E, Sehgal A, Khuffash AE, McNamara PJ (2014) Targeted neonatal echocardiography services: need for standardized training and quality assurance. J Ultrasound Med 33(10):1833–1841

    Article  PubMed  Google Scholar 

  17. Segal A, Mehta S, McNamara PJ, Evans N (2014) Cardiac sonography by the neonatologist: clinical usefulness and educational perspective. J Ultrasound Med 33(8):1401–1406

    Article  Google Scholar 

  18. Jaeel P, Sheth M, Nguyen J (2017) Ultrasonography for endotracheal tube position in infants and children. Eur J Pediatr 176(3):293–300

    Article  PubMed  Google Scholar 

  19. Katheria AC, Fleming SE, Kim JH (2013) A randomized controlled trial of ultrasound-guided peripherally inserted central catheters compared with standard radiograph in neonates. J Perinatol 33(10):791–794

    Article  CAS  PubMed  Google Scholar 

  20. Oleti T, Jeeva SM, Thukral A, Sreenivas V, Gupta A et al (2019) Does ultrasound guidance for peripherally inserted central catheter (PICC) insertion reduce the incidence of tip malposition? A randomized trial. J Perinatol 39(1):95–101

    Article  PubMed  Google Scholar 

  21. Harris PA, Taylor R, Thielke R, Payne J, Gonzalez N, Conde JG (2009) Research electronic data capture (REDCap)—a metadata-driven methodology and workflow process for providing translational research informatics support. J Biomed Inform 42(2):377–381

    Article  Google Scholar 

  22. Ailon J, Mourad O, Nadjafi M, Cavalcanti R (2016) Point-of-care ultrasound as a competency for general internists: a survey of internal medicine training programs in Canada. CMEJ 7(2):e51–e56

    PubMed  Google Scholar 

  23. Raimondi F, Porzio S, Balestriere L, Esposito P, Santantonio A et al (2017) Basic-targeted echocardiography for neonatologists: a trainee’s perspective. J Matern Fetal Neonatal Med 30(9):1032–1034

    Article  PubMed  Google Scholar 

  24. Ma IWY, Arishenkoff S, Wiseman J, Desy J, Ailon J et al (2017) Internal Medicine Point-of-Care Ultrasound Curriculum: consensus Recommendations from the Canadian Internal Medicine Ultrasound (CIMUS) Group. J Gen Intern Med 32(9):1052–1057

    Article  PubMed  PubMed Central  Google Scholar 

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Correspondence to Nadya Ben Fadel.

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All the authors named in the submission of this article declare that they have no conflict of interest.

Ethical standards

The Children’s Hospital of Eastern Ontario (CHEO) Research Ethics Board approved the study protocol. Participation in this study was voluntary and responding to the survey was considered implied consent.

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Informed consent was obtained from all individual participants included in the study.

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Ben Fadel, N., Pulgar, L. & Khurshid, F. Point of care ultrasound (POCUS) in Canadian neonatal intensive care units (NICUs): where are we?. J Ultrasound 22, 201–206 (2019). https://doi.org/10.1007/s40477-019-00383-4

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  • DOI: https://doi.org/10.1007/s40477-019-00383-4

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