Point-of-Care Ultrasound in Pediatric Hospital Medicine: A National Survey.

Abstract

Objective: To assess the current use, barriers, facilitators, and clinical applications of point-of-care ultrasonography (POCUS) within pediatric hospital medicine (PHM) groups across the United States, aiming to identify opportunities for broader implementation.

Methods: Using the Pediatric Research in Inpatient Setting (PRIS) Network, we conducted an anonymous, multicenter, cross-sectional survey targeting PHM groups in both academic children's hospitals and community settings. Descriptive and inferential statistics were used to identify the proportion of PHM divisions using POCUS, the associated characteristics of these groups, their current POCUS applications, and the barriers and facilitators for POCUS implementation.

Results: Of the 97 sites surveyed, 56% (n = 54) responded. Of these, 17% (n = 9) reported having a POCUS program. There was no significant difference in POCUS implementation among PHM divisions concerning geographic location, practice setting, number of beds, or faculty. Programs utilizing POCUS identified the following as principle uses: diagnosis of pleural effusions, pneumonia, pericardial effusions, bladder volume, and skin and soft tissue infections and performance of lumbar punctures. Among PHM groups with a POCUS program, 100% had a trained POCUS leader, 78% had dedicated equipment for their division, and 67% had available institutional training for their PHM group. The top barriers identified by PHM groups without a POCUS program included a lack of local POCUS experts, lack of equipment, and cost of equipment.

Conclusion: In 2024, more than 1 in 6 PHM divisions responding to this survey actively incorporated POCUS in the care of patients. These applications are diverse and applicable across common inpatient diagnoses.