• Richard Amini, Michael T Wyman, Nicholas C Hernandez, John A Guisto, and Srikar Adhikari.
• Department of Emergency Medicine, University of Arizona, Tucson, Arizona, USA.
• J Ultrasound Med. 2017 May 1; 36 (5): 913-921.

ObjectivesDespite the increased educational exposure to point-of-care ultrasound (US) at all levels of medical training, there are utilization gaps between academic and nonacademic emergency department (ED) settings. The purpose of this study was to assess the current practices and potential barriers to the use of point-of-care US in nonacademic EDs throughout the state of Arizona.MethodsWe conducted a cross-sectional study. An online questionnaire was electronically sent to all nonacademic EDs in Arizona. The survey consisted of questions regarding demographics, current practice patterns, policies, interdepartmental agreements, and perceptions regarding the use of point-of-care US.ResultsSeventy nonacademic EDs were identified for inclusion in our study, and 58 EDs completed the survey, which represented an 83% response rate. Seventy-eight percent (95% confidence interval [CI], 67%-89%) perform or interpret point-of-care US examinations for patient care. The 3 most common applications of point-of-care US reported by respondents were focused assessment with sonography for trauma, cardiac US examinations, and line placement, and 36% (95% CI, 22%-50%) bill for point-of-care US examinations. At 75% (95% CI, 62%-88%) of EDs, no one is specifically responsible for reviewing point-of-care US examinations for quality assurance, and at 50% (95% CI, 35%-65%), no mechanism exists to archive images. Eighty-three percent (95% CI, 72%-94%) of EDs think that their groups will benefit from the American College of Emergency Physicians Clinical Ultrasound Accreditation Program.ConclusionsUltrasound equipment is available in nearly all nonacademic EDs in Arizona. However, it appears that most providers lack US training, credentialing, quality assurance, and reimbursement mechanisms.© 2017 by the American Institute of Ultrasound in Medicine.

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