Comprehensive audit of an entire year of Point of Care Ultrasound Scans in an Internal Medicine Department

Abstract

Introduction: Point of care ultrasound (POCUS) is an increasingly popular tool used in the care of medical patients by Acute and General Internal Medicine Physicians. This is an audit of the first year of a UK District General Hospital Acute medicine department using POCUS; to try to determine when, where, why and how effectively the imaging modality is being used. We developed a novel reporting system whereby an electronic reporting template was used as part of the mandatory reporting of scans. Method: Due to our electronic medical records we were able to use our novel reporting system to comprehensively collect data from all formally reported scans over the course of 12 months. Each scan was assessed according to the following parameters: time from admission to when the scan was performed; how the scan contributed to or changed a patient's management, subsequent requirement for formal departmental imaging and how many scans were performed by trainees. Results: We were able to collect the data from 585 scan reports. The majority of which were thoracic scans, with a number of Echo, DVT and renal scans. The minority were for procedural scans. Over 50% of the scans were undertaken on the Acute Assessment Unit, with the Same Day Emergency Care Unit and Emergency Department making up the rest. A significant proportion of the scans negated the need for departmental imaging, which highlights the potential for reducing the workload for radiology and improving patient flow through the Acute Medical wards. Conclusion: POCUS is an established practice in Critical Care and Emergency Medicine however its utility in General Medicine is expanding and evolving. Therefore, this work attempts to understand how POCUS is being used in this setting to highlight areas for further development. We believe this is the first work of its kind in Acute or General Medicine in the United Kingdom and the results will help inform practice both locally and potentially nationally, to help other units who are considering developing their own POCUS service.