Best Practices for Point of Care Ultrasound: An Interdisciplinary Expert Consensus.

Despite the growing use of point of care ultrasound (POCUS) in contemporary medical practice and the existence of clinical guidelines addressing its specific applications, there remains a lack of standardization and agreement on optimal practices for several areas of POCUS use. The Society of Point of Care Ultrasound (SPOCUS) formed a working group in 2022 to establish a set of recommended best practices for POCUS, applicable to clinicians regardless of their training, specialty, resource setting, or scope of practice. Using a three-round modified Delphi process, a multi-disciplinary panel of 22 POCUS experts based in the United States reached consensus on 57 statements in domains including: (1) The definition and clinical role of POCUS; (2) Training pathways; (3) Credentialing; (4) Cleaning and maintenance of POCUS devices; (5) Consent and education; (6) Security, storage, and sharing of POCUS studies; (7) Uploading, archiving, and reviewing POCUS studies; and (8) Documenting POCUS studies. The consensus statements are provided here. While not intended to establish a standard of care or supersede more targeted guidelines, this document may serve as a useful baseline to guide clinicians, leaders, and systems considering initiation or enhancement of POCUS programs.

A clinician's guide to pulmonary hypertension.

ABSTRACT: Despite advances in diagnosis and treatment, pulmonary hypertension has high morbidity and mortality. The presenting symptoms often are vague and may mimic other more common diseases, so patients can be misdiagnosed or missed early in the disease process. Early detection of pulmonary hypertension by primary care providers can play an important role in patient outcomes and survival. Identifying signs and symptoms, understanding the causes and classifications, and knowing the systematic approach to evaluating and diagnosing patients with suspected pulmonary hypertension are key to preventing premature patient decline.

Point-of-care ultrasound assessment of the abdominal aorta by physician assistant students: a pilot study.

OBJECTIVE: Point-of-care ultrasound (POCUS) decreases time to diagnosis and improves mortality of those diagnosed with abdominal aortic aneurysms and dissections. While medical students have demonstrated an ability to obtain adequate POCUS images of the abdominal aorta (AA), physician assistant (PA) student studies are lacking. This pilot study aims to evaluate the ability of PA students to acquire AA POCUS images. METHODS: PA students, instructors, and models voluntarily participated. Student participants received online material to review several weeks before the study. During the study, students performed 4 precepted practice scans of the AA, and their fifth scan was recorded for review by three ultrasound fellowship trained Emergency Medicine physicians. Images were graded on proper identification and measurement of the AA, as well as interpretability of images. RESULTS: A total of 20 PA students participated. Ninety-five percent were able to obtain interpretable transverse images of the distal aorta and longitudinal views of the aorta, and 65% were able to obtain interpretable transverse images of the proximal and mid aorta. CONCLUSIONS: In the most rigorous evaluation of student-obtained AA POCUS images to date, we found that PA students were able to obtain adequate AA images. PA students were able to image the distal and longitudinal aorta in the transverse plane where the majority of AAAs are found to a very high degree. Results demonstrate PA students' ability to learn POCUS and encourage PA education to take steps to incorporate POCUS education and development of competency standards for PA graduates.

Inspiring the Future of Physician Assistant Ultrasound Education: Lessons Learned From the Inaugural Yes, iScan Event.

PURPOSE: Point-of-care ultrasound (POCUS), despite its rapid integration into undergraduate medical education curriculum, remains underutilized among physician assistant (PA) programs, with a resultant training gap between PAs and their physician collaborators. Herein, we present the Yes, iScan Ultrasound event, piloted at the 2018 American Academy of PAs (AAPA) conference, as a means to generate PA student interest in, and introductory engagement with, the emerging clinical adjunct of POCUS. METHODS: Physician assistant students and instructors were recruited to voluntarily participate. Student participants received pre-event online training access. They then competed in a team-based 8-hour competition covering core POCUS concepts of image acquisition, interpretation, and clinical implementation. Student participants' pre- and post-event self-assessments of their knowledge of how ultrasound could be implemented into clinical practice were analyzed using a 2-tailed t-test. RESULTS: A total of 62 students participated in the competition, with a post-event response rate of 53%. Surveys demonstrated a statistically significant post-event increase in knowledge of how ultrasound integrates into clinical practice from 3.9 to 6 (7-point Likert scale, P-value < .01, 95% confidence interval -2.51 to -1.76). Seventy-nine percentage of students reported being highly engaged throughout the event, with 95% of students recommending recurring incorporation into future AAPA conferences. CONCLUSIONS: Students reported high engagement and a significant increase in their knowledge of how POCUS may integrate into clinical practice following their participation. Although these data suggest that such events are successful at generating enthusiasm for this emerging clinical adjunct, further studies on the impact of the event toward increased POCUS integration into PA education are recommended.