Clinical Report Addresses Need for POCUS Guidelines for NICU

A point-of-care ultrasonography (POCUS) program should be developed for use in the neonatal intensive care unit (NICU), according to a clinical report published online Nov. 28 in Pediatrics.

Noting that use of POCUS in emergency situations can be lifesaving in the NICU if performed in a timely manner, Dan L. Stewart, M.D., from Norton Children’s Neonatology Affiliated with University of Louisville School of Medicine in Kentucky, and colleagues describe the clinical landscape of neonatal POCUS.

The authors note that although there are increasing opportunities for POCUS training for neonatal providers, this training does not necessarily translate into expertise that can be applied in clinical care. Until program development and training guidelines are issued, recommendations have been developed for use of POCUS. These include establishment of a hospital-wide POCUS committee, which has oversight responsibilities for implementation and quality assurance of the POCUS program. This committee should include representatives from pediatric radiology and pediatric cardiology, as well as departments where POCUS is practiced. The scope of practice should be clearly delineated within the domains of expertise in neonatology; this will help avoid interdisciplinary conflict and identify the specific skills that require structured training. A quality assurance process should be developed that assesses image quality and interpretative accuracy. To promote skill development and prevent harm, timely feedback to providers is crucial.

“There is a perceived, pressing clinical need for proactive planning to disseminate POCUS skills,” the authors write. “However, its implementation is yet to be standardized and core elements and infrastructure are underdeveloped.”

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