Implementation of Point‑of‑Care ultrasound examination in general practice

Czech version

Authors: David Halata ^1,2,3; Dušan Zhoř ^1,3; Roman S Kulec ^3,4,5,6,7,8
Authors‘ workplace: Společnost všeobecného lékařství ČLS JEP, Pracovní skupina pro ultrazvuk v primární péči ¹; Ústav preventivního lékařství, Univerzita Karlova v Praze, Lékařská fakulta v Hradci Králové ²; Mezioborová pracovní skupina pro doporučené postupy, vzdělávání a výzkum v oblasti Point‑of‑Care ultrasonografie ³; Institut postgraduálního vzdělávání ve zdravotnictví, Výukové pracoviště Point‑of‑Care ultrasonografie, Praha ⁴; Masarykova nemocnice v Ústí nad Labem, Klinika anesteziologie, perioperační a intenzivní medicíny, Univerzita J. E. Purkyně v Ústí nad Labem ⁵; Zdravotnická záchranná služba Středočeského kraje, Kladno ⁶; Klinika anesteziologie, resuscitace a intenzivní medicíny, Univerzita Karlova v Praze, Lékařská fakulta v Hradci Králové, Fakultní nemocnice Hradec Králové ⁷; Fakulta zdravotnických studií, Univerzita J. E. Purkyně v Ústí nad Labem ⁸
Published in: Vnitř Lék 2023; 69(4): 237-241
Category: Main Topic
doi: https://doi.org/10.36290/vnl.2023.045

Overview

Point-of-Care ultrasonography (POCUS) is a method defined as a targeted ultrasound examination of patients with acute symptoms or syndromes that can be diagnosed by a healthcare worker at a site. The aim is to answer a specific diagnostic or therapeutic question or to ease the therapeutic procedure.

Recently in Europe, there has been an increase in implementing POCUS in many medical fields including primary health care. The Czech Society of General Practice (SVL ČLS JEP) has for several years been watching the use of POCUS in primary care in many European countries.

In August 2020, the committee of the Czech Society of General Practice charged the Working Group for ultrasound in primary care to start a project POCUS iGP – POCUS Implementation in General Practice aiming for the implementation of POCUS into daily practice in general medicine. An ultrasound device is required, as well as setting up the education and training courses with follow up courses and a consensual curriculum of skills, securing quality control mechanisms, proving with scientific evidence the reliability of POCUS when provided by GPs and setting up the final rules of competency and payment for performance. The current international trend of patient centred care in primary health settings and increasing competencies of GPs emphasises a need to implement new point of care diagnostic methods. One of which is point of care ultrasonography.

Scientific outcomes and published data from primary care and other fields of medicine show that even doctors who do not work in radiology departments are after a relatively short course able to independently provide POCUS examinations with high reliability. Establishment of the Czech Multidisciplinary Task Force Group for standards, education and research in Pointof- Care ultrasound support development of the POCUS implementation.

Keywords:

Primary care – general practitioner – POCUS – Point‑of‑Care ultrasonography

Sources

1. Aakjær Andersen C, Brodersen J, Davidsen AS, et al. Use and impact of point‑of‑care ultrasonography in general practice: a prospective observational study. BMJ Open. 2020;10(9):e037664.

2. Škulec R, Cmorej P, Durila M, et al. Curriculum urgentní ultrasonografie pro specialisty v oboru urgentní medicína. Anesteziol a Intenziv medicína. 2018;29(6):338-45.

3. Andersen CA, Frandsen AK, Valentiner‑Branth C, et al. Introducing point‑of‑care ultrasound in Danish general practice‑elucidating the use through a medical audit. Fam Pract. 2020.

4. Andersen CA, Holden S, Vela J, et al. Point‑of‑Care Ultrasound in General Practice: A Systematic Review. Ann Fam Med. 2019;17(1):61-9.

5. Aakjaer Andersen C, Brodersen J, Davidsen AS, Graumann O, Jensen MBB. Use and impact of point‑of‑care ultrasonography in general practice: a prospective observational study. BMJ Open. 2020;10(9):e037664.

6. Buerger AM, Clark KR. Point‑of‑Care Ultrasound: A Trend in Health Care. Radiol Technol. 2017;89(2):127-38.

7. Carelli F. GP workloads in Europe. Br J Gen Pract. 2004;54(502):390.

8. Fisher RF, Croxson CH, Ashdown HF, Hobbs FR. GP views on strategies to cope with increasing workload: a qualitative interview study. Br J Gen Pract. 2017;67(655):e148-e56.

9. Mengel‑Jorgensen T, Jensen MB. Variation in the use of point‑of‑care ultrasound in general practice in various European countries. Results of a survey among experts. Eur J Gen Pract. 2016;22(4):274-7.

10. Smallwood N, Dachsel M. Point‑of‑care ultrasound (POCUS): unnecessary gadgetry or evidence‑based medicine? Clin Med (Lond). 2018;18(3):219-24.

11. Varzgaliene L, Heerey A, Cox C, McGuinness T, McGuire G, Cals JW, et al. Point‑of‑care testing in primary care: needs and attitudes of Irish GPs. BJGP Open. 2018;1(4): bjgpopen17X101229.

12. Halata D, Zhor, D., Seifert, B., Skulec, R. Impelemtance point‑of‑care ultrazvukového vyšetření v primární péči v České republice. Praktický lékař. 2021;101(4):201-204.

13. Bahner DP, Adkins EJ, Hughes D, Barrie M, Boulger CT, Royall NA. Integrated medical school ultrasound: development of an ultrasound vertical curriculum. Crit Ultrasound J. 2013;5(1):6.

14. Rempell JS, Saldana F, DiSalvo D, Kumar N, Stone MB, Chan W, et al. Pilot Point‑of‑Care Ultrasound Curriculum at Harvard Medical School: Early Experience. West J Emerg Med. 2016;17(6):734-40.

15. Solomon SD, Saldana F. Point‑of‑care ultrasound in medical education-stop listening and look. N Engl J Med. 2014;370(12):1083-5.

16. Wakefield RJ, Weerasinghe A, Tung P, Smith L, Pickering J, Msimanga T, et al. The development of a pragmatic, clinically driven ultrasound curriculum in a UK medical school. Med Teach. 2018;40(6):600-6.

17. American Academy of Family Physicians (AAFP). Recommended Curriculum Guidelines for Family Medicine Residents Point of Care Ultrasound 2016 [Available from: https://www.aafp.org/dam/AAFP/documents/medical_education_residency/program_directors/Reprint290D_POCUS.pdf.

18. The Danish College of General Practitioners (DSAM) Ultrasound interest group. Common trunk.