Diagnostic Point-of-Care Ultrasound: Assessment Techniques for the Pediatric Trauma Patient - Trauma EXTRA Supplement -

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Publication Date: July 2019 (Volume 16, Supplement 7)

No CME for this activity

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Abstract

Emergency ultrasound is performed at the point of care to quickly answer focused clinical questions. Over the last 25 years, the use of this technique has expanded rapidly. The use of emergency ultrasound in the pediatric setting is increasing because it does not expose the patient to ionizing radiation, as compared to computed tomography (CT). Utilizing diagnostic point-of-care ultrasound (POCUS) for pediatric trauma patients in the emergency department (ED) can facilitate diagnosis at the bedside rather than sending the patient out of the department for another study. This supplement focuses on some of the common indications for diagnostic POCUS that may be useful in the setting of trauma, as found in the pediatric literature, or extrapolated from adult literature where pediatric evidence is scarce.

Excerpt From This Issue

The use of ultrasound at the point of care by emergency clinicians, as well as by other specialists, has become increasingly common over the last 25 years. Emergency POCUS can be used as a diagnostic test and also to visualize anatomy for procedural guidance. It allows the emergency clinician to rapidly rule in or rule out disease processes and guide ongoing investigation and management of patients in the ED. POCUS is a skill required by the Accreditation Council for Graduate Medical Education for emergency medicine residency training,¹ and it is supported by many organizations, including the American Medical Association, the American Academy of Pediatrics, the American College of Emergency Physicians, the American Board of Emergency Medicine, and the American Institute for Ultrasound in Medicine.

Pediatric emergency ultrasound has been slower to progress than adult emergency ultrasound. Of the more than 120 emergency ultrasound fellowships currently listed on the Society for Clinical Ultrasound Fellowships website, only 14 are pediatric-specific. However, the use of emergency ultrasound for pediatric patients has recently begun to formalize. The American Academy of Pediatrics, along with several emergency medicine and ultrasound societies, released a policy statement in 2015 that supported the use of POCUS by pediatric emergency physicians.² In 2016, a review was published that reported guidelines and training objectives for pediatric-specific POCUS applications.³ Most pediatric emergency medicine fellowship directors now consider POCUS to be an essential skill and many include formal POCUS training in their curricula.⁴