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Key messages What is already known on this subject?
Globally, numerous organisations have published emergency ultrasound training and credentialing recommendations.
What this study adds?
This study describes numerous training and credentialing guidelines in one location.
This study describes the variable execution of emergency ultrasound training and credentialing guidelines set forth by the American College of Emergency Physicians.
Introduction
In 2011, Moore described the progression to point of care ultrasound from its origins in World War I to its use by at least 22 different medical specialties. His team speculated that the future of point of care ultrasound would be challenged to better define the indications for its use, how to train and certify providers, and to structure policies and establish reimbursement practices. 1 Although their assessment was focused primarily on the USA, emergency ultrasound (EUS) is a practice that crosses international borders. Bedside EUS is used in nearly half of paediatric trauma centres in Canada, with high usefulness. 2 Similarly, healthcare providers in Africa have reported that pulmonary, musculoskeletal and cardiac ultrasound is used frequently. 3 Italian researchers found that point of care ultrasound evaluation of patients with undifferentiated hypotension had good and potentially great agreement with the final determined cause of the hypotension and could be used to guide first line treatments. 4 Even in the remote Amazon, physicians describe that obstetric and gynaecologic as well as hepatobiliary ultrasound are useful. 5
Despite this widespread acceptance that ultrasound is helpful when used by trained physicians, there is variability among leading organisations on how to certify competence in this skill ( table 1 ). Instead of providing a specific credentialing schema, the International Federation of Emergency Medicine (IFEM) published a framework for an EUS curriculum that can be adapted to meet specific national or regional expectations. 6 Generally, the varying organisations suggest there is a theoretical component to the education combined with an experiential or practical component. Some organisations complete the certification process with an assessment of one or both of these aspects of clinician-performed ultrasound.
Table 1
Indications | Teaching | Practical (total scans/positive) | Assessment | |
Australia | ||||
Australasian College of Emergency Medicine (ACEM) 7 8 | Core Abdominal aorta Trauma Cardiac Procedural guidance | Instructional workshop | Abdominal aorta (15/5) Trauma (25/5) Cardiac (25/8) 25 additional cardiac interpretations | Practical |
Additional |