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Objective: The aims of this study were to describe point-of-care ultrasound (POCUS) use by recent pediatric emergency medicine (PEM) fellowship graduates and identify associations between frequency and breadth of POCUS use with variations in POCUS training and current clinical practice environment., Methods: This was a cross-sectional online survey of recent PEM fellowship graduates. Chi-square and nonparametric tests were used to compare POCUS use among physicians with varying types of POCUS training and varying clinical practice environments., Results: Eighty-two percent of 143 respondents reported using POCUS in their past 10 shifts. There was no association between the methods of POCUS education and frequency or breadth of POCUS use. Pediatric emergency medicine fellowship graduates with additional POCUS fellowship training performed more scans and used more applications than those who completed a pediatrics or medicine-pediatrics residency before PEM fellowship only [median 15 (9, 20) vs 2 (1, 5) (P < 0.01) and median 11 (6.5, 13) vs 2 (1, 3) (P < 0.01), respectively]. Participants who worked in academic emergency departments performed more ultrasounds than those who did not [3.5 (1, 8) vs 1 (0, 2), P < 0.01] and used a greater breadth of applications [3 (1, 5) vs 1 (0, 3), P < 0.01]. Physicians who billed for POCUS studies were more likely to use POCUS (odds ratio, 2.8; 95% confidence interval, 1.1-7.3) with greater frequency [5 (2.3, 10) vs 2 (0.8, 5), P < 0.01] and use a broader range of applications [3 (2,6) vs 2 (0.8, 3.3), P < 0.01]., Conclusion: Most respondents report recent POCUS use in practice. Point-of-care ultrasound fellowship training, working in an academic emergency department, and having the ability to bill were associated with increased POCUS use., Competing Interests: Disclosure: The authors declare no conflict of interest., (Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.)

Abstract: As point-of-care ultrasound (POCUS) becomes standard practice in pediatric emergency medicine (PEM), it is important to have benchmarks in place for credentialing PEM faculty in POCUS. Faculty must be systematically trained and assessed for competency in order to be credentialed in POCUS and granted privileges by an individual institution. Recommendations on credentialing PEM faculty are needed to ensure appropriate, consistent, and responsible use of this diagnostic and procedural tool. It is our intention that these guidelines will serve as a framework for credentialing faculty in PEM POCUS., Competing Interests: Disclosure: The authors declare no conflict of interest., (Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.)

The utility of point-of-care ultrasound is well supported by the medical literature. Consequently, pediatric emergency medicine providers have embraced this technology in everyday practice. Recently, the American Academy of Pediatrics published a policy statement endorsing the use of point-of-care ultrasound by pediatric emergency medicine providers.  To date, there is no standard guideline for the practice of point-of-care ultrasound for this specialty. This document serves as an initial step in the detailed "how to" and description of individual point-of-care ultrasound examinations.  Pediatric emergency medicine providers should refer to this paper as reference for published research, objectives for learners, and standardized reporting guidelines.

Sixteen Arab lactating mares belonging to Al-Zahraa Arab Horse Stud underwent two ultrasound examinations at 3 weeks interval starting from the day of demonstration of foaling heat. In addition, daily blood samples were collected from parturition until after exhibiting first postpartum estrus (day 11) with daily observation of estrous signs. Both leptin and estradiol hormones were assayed. Mean day of foaling heat was 8.9+/-0.9 day. Most mares came in foaling heat during days 9 and 10 had high conception rate compared to those who came in estrus earlier or later. Estradiol levels were high after day of foaling then decrease after expression of foaling heat. But leptin levels increase from day 8 to day 10 compared to other days before and after the first ovulation. A significant positive correlation was found between estradiol and leptin (r=0.58, p<0.025). The positive correlation between leptin and estradiol led us to suggest that leptin hormone plays an important role in ovulation of the first postpartum estrus in mares.