Point of Care Ultrasound in Pediatric Emergency Medicine: The Israeli Experience

Objective: Israel experienced robust adoption of point of care ultrasound (POCUS) over the last four years. We describe the state of the field in Israel, and discuss barriers to further implementation.

Methods: We completed a survey study detailing attitudes and experience of pediatric emergency directors, physicians and fellows in Israel using POCUS.

Results: 18 of 22 PED directors and 51 of 54 PED physicians responded. 24% of PEDs have had an ultrasound machine in the PED for the last 3-4 years, while all others report receiving an ultrasound machine more recently. 3.9% of PEM physicians had a year of POCUS fellowship and 11.8% had one to three months of fellowship. The average Likert score for self-confidence across seventeen POCUS examinations was 3.8 when reported by respondents with formal training over a month in duration versus 2.4 for respondents with less than a month of training. Respondents with a year of fellowship or more reported a Likert of 4.6 versus 3.6 for fellows with training experiences of between one month and three months. The top four impediments to routine use of POCUS are lack of self-confidence, lack of formal training, the requirement that a formal radiology examination be completed in order to confirm the POCUS finding and concern for medicolegal risk

Conclusion: POCUS has been introduced to Israel fairly recently, but adopted widely. Formal training of one month or longer improves self-confidence. Training and medicolegal education might further enhance implementation of POCUS into the daily practice of PEM physicians in Israel.