A survey of bedside ultrasound use by emergency physicians in California.
OBJECTIVE
The purpose of this study was to investigate the current practice of emergency physician-performed bedside ultrasound examinations in California and to assess differences between academic and community practice.


METHODS
We queried all emergency departments (EDs) in California to determine whether bedside ultrasound was used by emergency physicians. Among EDs that were using bedside ultrasound, we administered a survey to assess use patterns, credentialing criteria, and quality assurance (QA) programs.


RESULTS
We contacted all eligible EDs (n = 293) by telephone and had a 100% response rate for our primary question: 101 EDs (34%) reported use of bedside ultrasound. Of these 101 EDs, 97 (96%) responded to the secondary survey, showing the following: (1) 48% of physicians at each site were credentialed to use ultrasound in at least 1 modality; (2) 70% of EDs used American College of Emergency Physicians (ACEP) criteria for credentialing guidelines; and (3) 33% had an ultrasound QA program. Comparing practice settings, 68% of academic departments used bedside ultrasound compared with 29% of community departments (difference, 39%; 95% confidence interval [CI], 23% to 54%; P < .0001). In academic departments, a mean of 60% of physicians were credentialed, compared with 41% in community EDs (difference, 19%; 95% CI, 2.5% to 35%; P = .036).


CONCLUSIONS
Most California EDs do not use bedside ultrasound. Although most EDs using ultrasound report that they follow ACEP emergency ultrasound guidelines, most do not have a QA program as recommended by these guidelines. Compared with community EDs, academic EDs are more likely to use bedside ultrasound, have physicians credentialed in ultrasound use, and have QA programs.
Stein
John C
JC
Division of Emergency Medicine, University of California, 505 Parnassus Ave, Box 0208, San Francisco, CA 94143, USA. jstein@medicine.ucsf.edu
River
Gerin
G
Kalika
Irina
I
Hebig
Anke
A
Price
Daniel
D
Jacoby
Vanessa L
VL
Filly
Roy
R
D000046:Academic Medical Centers; D002140:California; D003406:Credentialing; D003430:Cross-Sectional Studies; D004635:Emergency Medicine / Q000379:methods* / Q000592:standards / Q000706:statistics & numerical data; D004636:Emergency Service, Hospital; D019538:Health Care Surveys; D006764:Hospitals, Community; D006801:Humans; D019095:Point-of-Care Systems / Q000706:statistics & numerical data*; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011785:Quality Assurance, Health Care; D014463:Ultrasonography / Q000379:methods / Q000592:standards / Q000706:statistics & numerical data*