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© 2009 by the American Institute of Ultrasound in Medicine
J Ultrasound Med 28:757-763 • 0278-4297

A Survey of Bedside Ultrasound Use by Emergency Physicians in California

John C. Stein, MD, Gerin River, BA, Irina Kalika, MD, Anke Hebig, BA, Daniel Price, MD, Vanessa L. Jacoby, MD and Roy Filly, MD

Division of Emergency Medicine (J.C.S.) and Departments of Obstetrics and Gynecology (V.L.J.) and Radiology (R.F.), University of California, San Francisco, California USA; University of California, San Francisco, California USA (G.R., A.H.); Department of Emergency Medicine, University of California, Davis, California USA (I.K.); and Alameda County Medical Center, Oakland, California USA (D.P.).

Address correspondence to John C. Stein, MD, Division of Emergency Medicine, University of California, 505 Parnassus Ave, Box 0208, San Francisco, CA 94143 USA., E-mail: jstein{at}medicine.ucsf.edu

Objective. The purpose of this study was to investigate the current practice of emergency physician–performed bedside ultrasound examinations in California and to assess differences between academic and community practice. Methods. We queried all emergency departments (EDs) in California to determine whether bedside ultrasound was used by emergency physicians. Among EDs that were using bedside ultrasound, we administered a survey to assess use patterns, credentialing criteria, and quality assurance (QA) programs. Results. We contacted all eligible EDs (n = 293) by telephone and had a 100% response rate for our primary question: 101 EDs (34%) reported use of bedside ultrasound. Of these 101 EDs, 97 (96%) responded to the secondary survey, showing the following: (1) 48% of physicians at each site were credentialed to use ultrasound in at least 1 modality; (2) 70% of EDs used American College of Emergency Physicians (ACEP) criteria for credentialing guidelines; and (3) 33% had an ultrasound QA program. Comparing practice settings, 68% of academic departments used bedside ultrasound compared with 29% of community departments (difference, 39%; 95% confidence interval [CI], 23% to 54%; P < .0001). In academic departments, a mean of 60% of physicians were credentialed, compared with 41% in community EDs (difference, 19%; 95% CI, 2.5% to 35%; P = .036). Conclusions. Most California EDs do not use bedside ultrasound. Although most EDs using ultrasound report that they follow ACEP emergency ultrasound guidelines, most do not have a QA program as recommended by these guidelines. Compared with community EDs, academic EDs are more likely to use bedside ultrasound, have physicians credentialed in ultrasound use, and have QA programs.

Key Words: bedside ultrasound • emergency medicine • emergency physicians

Abbreviations: ACEP, American College of Emergency Physicians • AIUM, American Institute of Ultrasound in Medicine • AMA, American Medical Association • CI, confidence interval • ED, emergency department • FAST, focused assessment with sonography for trauma • OSHPD, Office of Statewide Health Planning and Development • QA, quality assurance

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Copyright © 2009 by the American Institute of Ultrasound in Medicine.