Remote guidance and focused point-of-care ultrasound (POCUS) training for cardiopulmonary instability assessment by novice sonographers.
Resuscitation plus · 2025-12-04 · Method & validation
Abstract
OBJECTIVE: Bedside point-of-care ultrasound (POCUS) is effective to assess patients with cardiopulmonary instability, but experienced personnel is unavailable in secluded locations. We tested whether remote guidance support and a focused POCUS education would allow the acquisition of sufficient diagnostic quality and interpretation of selected cardiopulmonary POCUS views by untrained personnel. METHODS: We recruited 22 volunteer adults with little to no POCUS experience. We asked participants to obtain six POCUS heart, lung and abdominal views on healthy volunteers: at baseline; with remote guidance; and independently after a 2-h POCUS training session. Expert sonographers scored the diagnostic image quality (0, 0.5, or 1). Last, participants interpreted 24 previously recorded POCUS images: 2 normal and 22 abnormal (cardiogenic shock, tamponade, intra-abdominal bleeding, pneumonia, pleural effusion). RESULTS: The image quality of all six POCUS views at baseline was inadequate for clinical use in >80 % of participants. Image quality of all views improved with remote guidance in >70 % of participants and 2-h training in >50 % of participants. Quality scores improved from baseline with remote guidance in all views, and with training in four views. Lung views had the highest quality improvement. Participants correctly identified as abnormal 72.8 % of images, but only 52.8 % of normal ones. Pneumonia was the condition most correctly identified after training. CONCLUSIONS: Remote guidance, better than focused training, allowed novice sonographers to obtain selected POCUS views of sufficient diagnostic quality. Abnormal POCUS images were identified more reliably than normal ones. Education was most effective for acquiring lung POCUS views and pneumonia detection.