• Summer L Kaplan, Aaron E Chen, Rachel G Rempell, Nafis Brown, Maria C Velez-Florez, and Asef Khwaja.
• Director of Emergency Radiology, Department of Radiology, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania. Electronic address: kaplans2@email.chop.edu.
• J Am Coll Radiol. 2020 Dec 1; 17 (12): 1555-1562.

PurposePoint-of-care ultrasound (POCUS) is growing, but few data exist regarding its effects on radiology ultrasound (Rad US) volumes. The authors studied changes in Rad US ordered by emergency medicine (EM) as POCUS began and grew at their pediatric hospital.MethodsThis retrospective study included EM POCUS and EM-ordered Rad US volumes between 2011 and 2017, during three 2-year intervals: before POCUS, early POCUS, and expanded POCUS. Changes in overall Rad US and POCUS volumes per visit during these intervals were studied. Changes in skin and soft tissue infection (SSTI) US per SSTI visit, an examination performed diagnostically by both radiology and EM, were also assessed. Volume differences were examined using the Mann-Whitney U test (significance threshold, P < .05), and process control charts were used to identify nonrandom variations.ResultsThe study included 49,908 Rad US and 2,772 POCUS examinations during 647,890 emergency department visits. Rad US volumes per visit remained unchanged during early POCUS (P = .858) but increased with expanded POCUS (P < .005). A transient nonrandom increase in Rad US occurred as POCUS began. SSTI Rad US per SSTI visit significantly increased (P < .001) during early POCUS but did not change with expanded POCUS (P = .143). An SSTI management pathway in the emergency department before expanded POCUS may have affected ordering. Other variation occurred in proximity to practice changes and seasonal patterns.ConclusionsRad US overall and specifically for SSTI increased or remained stable during the introduction and growth of EM POCUS. Rather than decreasing Rad US, EM POCUS had a complementary role.Copyright © 2020 American College of Radiology. Published by Elsevier Inc. All rights reserved.

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