This is an independent survey among the CLUS in Australasian EDs, depicting the reality of emergency ultrasound (EUS) regarding EUS core pillars of governance, infrastructure, administration, education and quality assurance (QA). A total of 98 responses from CLUS representing 98 EDs were analysed (response rate of 96% and a completion rate of 94%).
Key findings:
15% of CLUS had no ultrasound qualification (CCPU 57%, DDU 18%, Others 9%, None 15%).
Only 66% of CLUS had dedicated clinical support time (CST), and the majority of CLUS preferred 2days per fortnight of CST.
Mere 5% of CLUS had administrative personnel support.
Only 20 EDs had sonographer educator in the ED (SEED), and most (13/20) were in temporary appointments.
Only 26% of EDs had secured image archiving facilities, of which only 20% of EDs EUS images were readily accessible to other clinicians.
Only 56% of EDs had a formal transducer disinfection protocol, and only 35% of EDs had HLD equipment for transducer disinfection.
Only 32% of EDs had an Ultrasound Special Skills program for ED Advanced trainees.
Only 50% of EDs had an in-house EUS credentialing programme.
Only 11% of EDs reported having a regular EUS training program for FACEMs.
Reporting templates were available in only 38% of EDs, and only 33% of EDs provided a formal report on EUS examinations.
Only 37% of EDs had conducted an audit on the quality of EUS at some stage.
Results of this survey remind us of the long way that we have to travel to reach a safer place in the performance of emergency physician performed ultrasound. It is not just long but an arduous steep course with interesting political and financial hurdles to overcome. Undertaking such a mammoth task alone as a sole CLUS within your institution will be an inevitable failure. A task of this magnitude requires a unified movement to push things in the right direction. Fortunately, we have great POCUS leaders spread across both sides of the Tasman Sea to lead a successful movement. It is time to increase the amplitude of our sound, let it echo, reverberate, heat things up and resonate, till it's heard by those who have selective hearing loss. The voice should accompany a futuristic plan to advance EUS in the language comprehensible by administrators and decision-makers. Organisations like EMUGs and ASUM have done a great job uniting clinicians interested in sonography, promoting ultrasound education, creating guidelines and providing the much-needed support at the ground level. Productive integration of these organisations with ACEM in addressing the gaps identified in this survey would be an appreciable Top-Down approach. I’m sure all CLUS in Australasia will happily lend their supportive hand for one such approach from our governing bodies.
Good luck to us.
Dr Vijay Manivel
