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Establishing a risk assessment framework for point-of-care ultrasound.

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cam.issuedOnline2021-11-30
dc.contributor.authorConlon, Thomas W
dc.contributor.authorYousef, Nadya
dc.contributor.authorMayordomo-Colunga, Juan
dc.contributor.authorTissot, Cecile
dc.contributor.authorFraga, Maria V
dc.contributor.authorBhombal, Shazia
dc.contributor.authorSuryawanshi, Pradeep
dc.contributor.authorVillanueva, Alberto Medina
dc.contributor.authorSiassi, Bijan
dc.contributor.authorSingh, Yogen
dc.contributor.orcidSiassi, Bijan [0000-0002-4308-3753]
dc.contributor.orcidSingh, Yogen [0000-0002-5207-9019]
dc.date.accessioned2022-03-31T16:28:31Z
dc.date.available2022-03-31T16:28:31Z
dc.date.issued2022-04
dc.date.submitted2021-10-04
dc.date.updated2022-03-31T16:28:31Z
dc.description.abstractUNLABELLED: Point-of-care ultrasound (POCUS) refers to the use of portable ultrasound (US) applications at the bedside, performed directly by the treating physician, for either diagnostic or procedure guidance purposes. It is being rapidly adopted by traditionally non-imaging medical specialties across the globe. Recent international evidence-based guidelines on POCUS for critically ill neonates and children were issued by the POCUS Working Group of the European Society of Pediatric and Neonatal Intensive Care (ESPNIC). Currently there are no standardized national or international guidelines for its implementation into clinical practice or even the training curriculum to monitor quality assurance. Further, there are no definitions or methods of POCUS competency measurement across its varied clinical applications. CONCLUSION: The Hippocratic Oath suggests medical providers do no harm to their patients. In our continued quest to uphold this value, providers seeking solutions to clinical problems must often weigh the benefit of an intervention with the risk of harm to the patient. Technologies to guide diagnosis and medical management present unique considerations when assessing possible risk to the patient. Frequently risk extends beyond the patient and impacts providers and the institutions in which they practice. POCUS is an emerging technology increasingly incorporated in the care of children across varied clinical specialties. Concerns have been raised by clinical colleagues and regulatory agencies regarding appropriate POCUS use and oversight. We present a framework for assessing the risk of POCUS use in pediatrics and suggest methods of mitigating risk to optimize safety and outcomes for patients, providers, and institutions. WHAT IS KNOWN: • The use POCUS by traditionally non-imaging pediatric specialty physicians for both diagnostic and procedural guidance is rapidly increasing. • Although there are international guidelines for its indications, currently there is no standardized guidance on its implementation in clinical practice. WHAT IS NEW: • Although standards for pediatric specialty-specific POCUS curriculum and training to competency have not been defined, POCUS is likely to be most successfully incorporated in clinical care when programmatic infrastructural elements are present. • Risk assessment is a forward-thinking process and requires an imprecise calculus that integrates considerations of the technology, the provider, and the context in which medical care is delivered. Medicolegal considerations vary across countries and frequently change, requiring providers and institutions to understand local regulatory requirements and legal frameworks to mitigate the potential risks of POCUS.
dc.identifier.doi10.17863/CAM.82998
dc.identifier.eissn1432-1076
dc.identifier.issn0340-6199
dc.identifier.others00431-021-04324-4
dc.identifier.other4324
dc.identifier.urihttps://www.repository.cam.ac.uk/handle/1810/335567
dc.languageen
dc.language.isoeng
dc.publisherSpringer Science and Business Media LLC
dc.publisher.urlhttp://dx.doi.org/10.1007/s00431-021-04324-4
dc.subjectChildren
dc.subjectFramework
dc.subjectNeonates
dc.subjectPoint-of-care ultrasound (POCUS)
dc.subjectRisk assessment
dc.subjectChild
dc.subjectCurriculum
dc.subjectHumans
dc.subjectInfant, Newborn
dc.subjectPoint-of-Care Systems
dc.subjectPoint-of-Care Testing
dc.subjectRisk Assessment
dc.subjectUltrasonography
dc.titleEstablishing a risk assessment framework for point-of-care ultrasound.
dc.typeArticle
dcterms.dateAccepted2021-11-18
prism.endingPage1457
prism.issueIdentifier4
prism.publicationNameEur J Pediatr
prism.startingPage1449
prism.volume181
rioxxterms.licenseref.urihttp://creativecommons.org/licenses/by/4.0/
rioxxterms.versionVoR
rioxxterms.versionofrecord10.1007/s00431-021-04324-4

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