452 - Point of Care Ultrasound (POCUS) and the Pediatric Patient-Family Experience

Point-of-care ultrasound (POCUS) has become an increasingly important diagnostic tool for emergency department clinicians.  Current literature suggests that patients respond positively to the use of POCUS but very little is known about patient-family experience in the pediatric emergency department (ED). 

Objective:

We sought to determine differences in patient-family experience in those receiving POCUS compared to those without POCUS as part of their ED care.

Design/Methods: One hundred patient-families were randomized (1:1 ratio) into either a POCUS group or non-POCUS group after triage. Pediatric patients (age 0-17 years) presenting with a clinical indication for cardiac, lung, soft tissue, or focused assessment with sonography in trauma (FAST) were included. Unstable patients were excluded.  Participants completed a survey consisting of 15 Likert-scale questions prior to clinical evaluation and at the time of disposition. Patient electronic medical records were reviewed to determine ED length of stay. We compared mean responses between the two groups using a standard two-tailed t-test.

Results: All patient-families completed the presurvey, and 71% completed the post-survey.  Most patients were less than 2 years old (34%), Caucasian (62%), non-Hispanic (27%), and males (57%) with an indication for lung POCUS evaluation (34%). There were no differences observed between the two groups. Patients receiving POCUS had a significantly better ED experience with the care they received and physician confidence when compared to the non-POCUS group (4.77 + 0.11standard error of the mean [SEM] vs. 4.38 + 0.19; p = 0.0360) and (4.72 + 0.12 vs. 4.54 0.147; p = 0.172), respectively. POCUS use was associated with longer ED lengths of stay (263.2 minutes + 18.2 vs. 230.5 + 21.0), however, the average time spent for each POCUS evaluation was only 6.43 minutes (+ 0.66).

Conclusion(s): Our data suggest that POCUS significantly improves patient-family experience in the pediatric ED, and this further supports the use of POCUS in the clinical setting.