title: A majority of rural emergency departments in the province of Quebec use point-of-care ultrasound: a cross-sectional survey.
abstract: BACKGROUND
  Point-of-care ultrasound (POCUS) can be used to provide rapid answers to specific and potentially life-threatening clinical questions, and to improve the safety of procedures. The rate of POCUS access and use in Canada is unclear. The objective of this study was to examine access to POCUS and potential barriers/facilitators to its use among rural physicians in Quebec.
  
  
  METHODS
  This descriptive cross-sectional study used an online survey. The 30-item questionnaire is an adapted and translated version of a questionnaire used in a prior survey conducted in rural Ontario, Canada. The questionnaire was pre-tested for clarity and relevance. The survey was sent to non-locum physicians working either full- or part-time in rural emergency departments (EDs) (n = 206). All EDs were located in rural and small towns and provided 24/7 medical coverage with acute care hospitalization beds.
  
  
  RESULTS
  In total, 108 surveys were completed (participation rate = 52.4%). Of the individuals who completed surveys, ninety-three percent were family physicians, and seven percent had Canadian College of Family Physicians - Emergency Medicine (CCFP-EM) certification. The median number of years of practice was seven. A bedside ultrasound device was available in 95% of rural EDs; 75.9% of physicians reported using POCUS on a regular basis. The most common indications for POCUS use were to rule out abdominal aortic aneurysm (70.4%) and to evaluate presence of free fluid in trauma and intrauterine pregnancy (60%). The most common reason (73%) for not using POCUS was limited access to POCUS training programs. Over 40% of POCUS users received training in POCUS during medical school or residency. Sixty-four percent received training from the Canadian Emergency Ultrasound Society, 13% received training from the Canadian Association of Emergency Physicians, and 23% were trained in another course. Finally, 95% of respondents reported that POCUS skills are essential for rural ED practice.
  
  
  CONCLUSIONS
  POCUS use in rural EDs in the province of Quebec appears to be relatively widespread. Access to training programs is a barrier to greater use.
authors.affiliation: Department of Family and Emergency Medicine, Université Laval, Quebec City, QC, Canada. pierre.leger.1@ulaval.ca.
authors.forename: Pierre
authors.initials: P
authors.lastname: Léger
authors.affiliation: Department of Family and Emergency Medicine, Université Laval, Quebec City, QC, Canada. rfleet@videotron.ca.|Research Centre, Emergency Medicine Laval University - CHAU Hôtel-Dieu de Lévis Hospital, 143 Wolfe Street, Lévis, QC, G6V 3Z1, Canada. rfleet@videotron.ca.
authors.forename: Richard
authors.initials: R
authors.lastname: Fleet
authors.affiliation: Research Centre, Emergency Medicine Laval University - CHAU Hôtel-Dieu de Lévis Hospital, 143 Wolfe Street, Lévis, QC, G6V 3Z1, Canada. juliemgiguere@gmail.com.
authors.forename: Julie
authors.initials: J
authors.lastname: Maltais-Giguère
authors.affiliation: Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada. planj@mac.com.|Department of Emergency Medicine, Penticton Regional Hospital, Penticton, BC, Canada. planj@mac.com.
authors.forename: Jeff
authors.initials: J
authors.lastname: Plant
authors.affiliation: Department of Family and Emergency Medicine, Université de Montréal; Department of Emergency Medicine, Hôpital du Sacré-Coeur de Montréal, Montréal, QC, Canada. eric.piette@umontreal.ca.
authors.forename: Éric
authors.initials: É
authors.lastname: Piette
authors.affiliation: Department of Family Medicine and Emergency Medicine, Knowledge Transfer and Health Technology Assessment of the CHUQ Research Centre (CRCHUQ, Unité de Recherche Évaluative, Université Laval; Implementation of Shared Decision Making in Primary Care, Quebec City, QC, Canada. france.legare@mfa.ulaval.ca.
authors.forename: France
authors.initials: F
authors.lastname: Légaré
authors.affiliation: Department of Family and Emergency Medicine, Université Laval, Quebec City, QC, Canada. julien.poitras@fmed.ulaval.ca.|Research Centre, Emergency Medicine Laval University - CHAU Hôtel-Dieu de Lévis Hospital, 143 Wolfe Street, Lévis, QC, G6V 3Z1, Canada. julien.poitras@fmed.ulaval.ca.
authors.forename: Julien
authors.initials: J
authors.lastname: Poitras
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019095:Point-of-Care Systems / Q000706:statistics & numerical data*; D011792:Quebec; D019035:Rural Health Services / Q000706:statistics & numerical data*; D014463:Ultrasonography / Q000706:statistics & numerical data*