Time Isn't your FoCUS, do cardiac POCUS!

Abstract

Background

Physicians often cite time as a limitation to performing a focused cardiac ultrasound (FoCUS) exam. The primary outcome of this study was to determine the amount of time to complete a quality FoCUS exam. Secondary outcomes evaluated time differences between different training levels.

Methods

FoCUS exams were performed by emergency medicine (EM) residents, EM ultrasound (US) fellows, US fellowship-trained EM attendings, and EM attendings credentialed in US. Time to complete a FoCUS exam is the time difference between the first and final images acquired during the exam. Chi-square, t-tests, analysis of variance, and linear regression were performed to evaluate the data obtained in the study.

Results

Six-hundred FoCUS exams were included in the study. Of these, 34 % had 3 views and 55.5 % had 4 views. Most studies (78.9 %) had a quality rating of 4 or 5. The average time for all groups to complete a FoCUS was 3.4 min. Residents took 3.8 min while attendings took 3.1 min. On average, PGY1 residents took 4.6 min, PGY2 residents took 4.0 min, and PGY3 residents took 2.8 min (p ≤ 0.0001).

Conclusions

Our study shows EM physicians take approximately 3.4 min to complete a quality FoCUS exam and residents took 45 s longer compared to attendings. For resident physicians, the amount of time it takes to complete a quality FoCUS exam decreases over the course of residency training. Our findings suggest the amount of time to complete a quality FoCUS exam should not be a limitation to perform a FoCUS exam.