• Martien H Humblet, Yogen Singh, Cecile Tissot, Daniele De Luca, and Piet L Leroy.
• Pediatric Intensive Care Unit, Department of Pediatrics, Maastricht University Medical Centre, Maastricht, The Netherlands.
• Pediatr Crit Care Me. 2020 Sep 1; 21 (9): e716-e722.

Objectives1) To investigate the current practice in point-of-care ultrasound use in PICUs across Europe; 2) to understand the barriers for point-of-care ultrasound implementation in the clinical practice; 3) to identify existing point-of-care ultrasound training programs; and 4) to assess training needs.DesignCross-sectional electronic survey.SubjectsMedical directors of European PICUs.Measurements And Main ResultsThe response rate was 42.3%; 142 of the 336 invited PICU medical directors from 26 European countries completed the survey. The clinicians in almost all the PICUs across Europe were reported to use point-of-care ultrasound in some form. A significant variation in the clinical practice according to the patient characteristics and presence of a fellowship training program was observed. PICUs with cardiosurgical patients reported using point-of-care ultrasound significantly more often than others. Ultrasound-guided vascular access was the most common point-of-care ultrasound indication, except in PICUs providing joint care for neonates and children. Units with a fellowship training program reported an increased use of point-of-care ultrasound for hemodynamic evaluation, during resuscitation and a positive impact on collaboration with imaging specialties. Although no barrier was deemed substantial to impede point-of-care ultrasound implementation, a number of potential hindrances to its implementation were reported-such as lack of formal training curriculum, collaborative learning opportunities, and quality assurance processes. Bedside informal teaching in point-of-care ultrasound was reported the most common method to acquire point-of-care ultrasound skills.ConclusionsPoint-of-care ultrasound is being used extensively across heterogeneously organized PICU settings in Europe. However, there remains a significant variation in the clinical practice across the units. Clear needs for improved point-of-care ultrasound training programs and clinical governance structure were identified. Evidence-based point-of-care ultrasound guidelines, structured training programs dedicated to neonatal and pediatric intensive care settings, and educational research in point-of-care ultrasound use may help in strengthening clinical governance, making clinical practice uniform and enhancing quality assurance.

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