Implementation of point-of-care ultrasonography in an infectious disease ward

Abstract

Introduction: Point-of-care ultrasonography (POCUS) has emerged as an essential supplement to physical examination in many specialties. In contrast, its use by infectious diseases (ID) specialists remains anecdotal. Here, we report on the acquisition of an ultrasonography device in a French ID ward, and we describe its everyday use.

Methods: A preliminary audit was conducted to evaluate the potential impact of the acquisition of an ultrasonography device. A second audit was performed during the first year following the acquisition of the device to quantify its everyday use. We also evaluated the impact of POCUS implementation on medical imaging requests by comparing the number of intra-hospital transports before and after the acquisition.

Results: According to the first audit, 81 of the 199 (41%) imaging examinations that were prescribed during a two-month period could have been replaced by POCUS. During the first year following the acquisition of the ultrasonography device, POCUS was performed 240 times by 31 different operators. The operators were a senior physician, an intern, and a medical student in 94 (39%), 135 (57%), and 11 (5%) cases, respectively. The organs most frequently explored were the genito-urinary tract (n=74), the joints (n=35), and the lungs/pleura (n=35). Acquisition of the device was followed by a significant decrease in the number of transports to the ultrasonography room, whereas the total number of transports to the medical imaging ward did not change.

Conclusion: Opportunities to use POCUS in the ID ward are numerous. POCUS training should be part of the ID specialist's curriculum.

Keywords: Clinical practice; Infectious diseases; POCUS; Ultrasonography.