When to incorporate point-of-care ultrasound (POCUS) into the initial assessment of acutely ill patients: a pilot crossover study to compare 2 POCUS-assisted simulation protocols

Courtney E. Bennett, Sandhya Samavedam, Namita Jayaprakash, Alexander Kogan, Ognjen Gajic, Hiroshi Sekiguchi

Research output: Contribution to journalArticlepeer-review

3 Scopus citations

Abstract

BACKGROUND: The purpose of this study was to determine the ideal timing for providers to perform point-of-care ultrasound (POCUS) with the least increase in workload. METHODS: We conducted a pilot crossover study to compare 2 POCUS-assisted evaluation protocols for acutely ill patients: sequential (physical examination followed by POCUS) vs parallel (POCUS at the time of physical examination). Participants were randomly assigned to 2 groups according to which POCUS-assisted protocol (sequential vs parallel) was used during simulated scenarios. Subsequently, the groups were crossed over to complete assessment by using the other POCUS-assisted protocol in the same patient scenarios. Providers' workloads, measured with the National Aeronautics and Space Administration Task Load Index (NASA-TLX) and time to complete patient evaluation, were compared between the 2 protocols. RESULTS: Seven providers completed 14 assessments (7 sequential and 7 parallel). The median (IQR) total NASA-TLX score was 30 (30-50) in the sequential and 55 (50-65) in the parallel protocol (P = .03), which suggests a significantly lower workload in the sequential protocol. When individual components of the NASA-TLX score were evaluated, mental demand and frustration level were significantly lower in the sequential than in the parallel protocol (40 [IQR, 30-60] vs 50 [IQR, 40-70]; P = .03 and 25 [IQR, 20-35] vs 60 [IQR, 45-85]; P = .02, respectively). The time needed to complete the assessment was similar between the sequential and parallel protocols (8.7 [IQR, 6-9] minutes vs 10.1 [IQR, 7-11] minutes, respectively; P = .30). CONCLUSIONS: A sequential POCUS-assisted protocol posed less workload to POCUS operators than the parallel protocol.

Original languageEnglish (US)
Pages (from-to)14
Number of pages1
JournalCardiovascular ultrasound
Volume16
Issue number1
DOIs
StatePublished - Sep 11 2018

Keywords

  • Critical illness
  • Point-of-care
  • Simulation
  • Ultrasound

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

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