Emergency department ultrasound by nurse practitioners.
OBJECTIVE
Bedside ultrasound (u/s) examinations by emergency physicians (EPs) have been integrated into clinical emergency medicine (EM) training programs and the efficacy and success of an introductory u/s training course, based on established guidelines, has been previously described. We used this same course to teach EM nurse practitioners (NPs) bedside u/s and then assessed the adequacy of NP ultrasonography 1 year following the course.


METHODS
Five NPs were included in a standardized 16-h EM u/s training program. Subsequently, the NPs were asked to print consecutive u/s images representative of their clinical assessments. A single qualified EP reviewer assessed images for adequacy.


CONCLUSIONS
Five NPs reported 229 u/s examinations, two of which were excluded as nondiagnostic over the 2-month study period. There were 32 inadequate images and 27 "positive" findings. All the positives were correct. Totals per provider were 104, 58, 49, 13, and 3 u/s assessments with 83%, 95%, 84%, 77%, and 100% adequacy of images, respectively. Of the 32 inadequate images, 18 of these were incomplete focused assessment with sonography for trauma (FAST) examinations with a reading of negative for free fluid.


CONCLUSIONS
NPs are able to perform focused u/s with a high degree of accuracy, and a 16-h guideline-based course serves as a good introductory foundation.
Henderson
Sean O
SO
Department of Emergency Medicine, Keck/USC School of Medicine, Los Angeles, California 90033, USA. sohender@hsc.usc.edu
Ahern
Terence
T
Williams
David
D
Mailhot
Thomas
T
Mandavia
Diku
D
D003479:Curriculum; D004636:Emergency Service, Hospital; D006801:Humans; D009722:Nurse Practitioners; D019095:Point-of-Care Systems; D011446:Prospective Studies; D014463:Ultrasonography / Q000295:instrumentation / Q000379:methods*