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. 2020 Dec;10(4):239-242.
doi: 10.1016/j.afjem.2020.07.016. Epub 2020 Sep 3.

A descriptive study of the use of cardiac point of care ultrasound (PoCUS) in public emergency centres in Cape Town

Ushira Ganas  1 , Jacques J Malan  1 , Stevan R Bruijns  1
Affiliations

A descriptive study of the use of cardiac point of care ultrasound (PoCUS) in public emergency centres in Cape Town

Ushira Ganas et al. Afr J Emerg Med. 2020 Dec.

Abstract

Introduction: The indications for cardiac point of care ultrasound (PoCUS) vary somewhat in different parts of the world, and training programs may also differ. We set out to describe the self-reported cardiac PoCUS indications and imaging windows used at a selection of secondary-level, public hospital emergency centres in Cape Town.

Methods: A descriptive study with prospective data collected from emergency centres of Mitchells Plain District, Victoria and New Somerset Hospitals in Cape Town were used. Data were collected over a three-month period by providers who have completed a basic emergency ultrasound course, using a purpose-designed data collection tool for all cardiac PoCUS scans.

Results: Fifteen PoCUS providers recorded 267 data entries over the three-month study period; there were 17 exclusions, leaving 250 entries for analysis. The most common indication for performing cardiac PoCUS was electrocardiogram abnormalities, 27% (n = 112); dyspnoea, 25% (n = 102); chest pain, 16% (n = 65); cardiomegaly on chest x-ray, 12% (n = 51); new murmur, 6% (n = 23); and chest trauma, 5% (n = 22). Other indications made up the remaining 10% (n = 40). Parasternal long and short axis were the predominantly used views.

Conclusion: Cardiac PoCUS is used for a wide range of indications beyond the recommended training guidelines. Some indications may be more useful in low- to middle-income settings. Further research needs to be done to ascertain the extent of the use of cardiac PoCUS, and possibly the need for a more comprehensive training program with adequate training in these clinical conditions, to ensure safe practice.

Keywords: Bedside ultrasound; Cardiac PoCUS; Emergency centre ultrasound; Low-middle income settings.

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