Barriers to Point-of-Care Ultrasound in Anesthesiology
Abstract:
Objectives: The purpose of this study was to determine current use, training needs, and barriers to point-of-care ultrasound (POCUS) use among anesthesiologists in practice.
Design: Multicenter, prospective, observational study.
Setting: Anesthesiology departments in the Veterans Affairs Healthcare System in the United States.
Participants: Chiefs of staff and chiefs of anesthesiology departments.
Interventions: A web-based survey was conducted between June 2019 and March 2020. Chiefs of staff answered questions about facility-level POCUS use, training, competency, and policies. Anesthesiology chiefs responded to a follow-up survey with specialty-specific POCUS questions. The results of the 2020 survey were compared with a similar survey conducted by the authors’ group in 2015.
Measurements and main results: All chiefs of staff (n = 130) and 77% of anesthesiology chiefs (n = 96) completed the survey. The most common POCUS applications used were central and peripheral vascular access (69%-72%), peripheral nerve blocks (66%), and evaluation of cardiac function (29%-31%). Compared with 2015, there was a statistically significant increase in desire for training (p = 0.00015), but no significant change in POCUS use (p = 0.31). Training was most desired for volume-status assessment (52%), left ventricular function (47%), pneumothorax (47%), central line placement (40%), peripheral nerve blocks (40%), and pleural effusion (40%). The most common barriers to POCUS use were lack of funding for training (35%), trained providers (33%), and training opportunities (28%).
Conclusions: A significant increase in desire for POCUS training was seen among anesthesiologists practicing in the Veterans Affairs healthcare system since 2015, and lack of training continues to be a top barrier for POCUS use among anesthesiologists.
Reference:
Remskar MH, Theophanous R, Bowman A, Simonson LE, Koehler J, Basrai Z, Manohar CM, Mader MJ, Nathanson R, Soni NJ. Current Use, Training, and Barriers of Point-of-Care Ultrasound in Anesthesiology: A National Survey of Veterans Affairs Hospitals. J Cardiothorac Vasc Anesth. 2023 Apr 5:S1053-0770(23)00229-X. doi: 10.1053/j.jvca.2023.03.042. Epub ahead of print. PMID: 37120325.