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BackgroundThe Pediatric Emergency Medicine (PEM) Point-of-care Ultrasound (POCUS) Network (P2Network) was established in 2014 to provide a platform for international collaboration among experts, including multicenter research. The objective of this study was to use expert consensus to identify and prioritize PEM POCUS topics, to inform future collaborative multicenter research.MethodsOnline surveys were administered in a two-stage, modified Delphi study. A steering committee of 16 PEM POCUS experts was identified within the P2Network, with representation from the United States, Canada, Italy, and Australia. We solicited the participation of international PEM POCUS experts through professional society mailing lists, research networks, social media, and "word of mouth." After each round, responses were refined by the steering committee before being reissued to participants to determine the ranking of all the research questions based on means and to identify the high-level consensus topics. The final stage was a modified Hanlon process of prioritization round (HPP), which emphasized relevance, impact, and feasibility.ResultsFifty-four eligible participants (16.6%) provided 191 items to Survey 1 (Round 1). These were refined and consolidated into 52 research questions by the steering committee. These were issued for rating in Survey 2 (Round 2), which had 45 participants. At the completion of Round 2, all questions were ranked with six research questions reaching high-level consensus. Thirty-one research questions with mean ratings above neutral were selected for the HPP round. Highly ranked topics included clinical applications of POCUS to evaluate and manage children with shock, cardiac arrest, thoracoabdominal trauma, suspected cardiac failure, atraumatic limp, and intussusception.ConclusionsThis consensus study has established a research agenda to inform future international multicenter PEM POCUS trials. This study has highlighted the ongoing need for high-quality evidence for PEM POCUS applications to guide clinical practice.

Objectives: There has been a steady increase in the growth and utilization of point‐of‐care ultrasound (POCUS) in pediatric emergency medicine (PEM). POCUS has been established as an Accreditation Council for Graduate Medical Education (ACGME) core requirement for accreditation of PEM fellowship programs. Despite this requirement, training guidelines regarding POCUS knowledge and skills have yet to be developed. The purpose of this project was to develop a curriculum and a competency checklist for PEM fellow POCUS education. Methods: We formed a core leadership group based on expertise in one or more key areas: PEM, POCUS, curriculum development, or Delphi methods. We recruited 29 PEM POCUS or ultrasound education experts from North America to participate in a three‐round electronic Delphi project. The first Delphi round asked experts to generate a list of the core POCUS knowledge and skills that a PEM fellow would need during training to function as an autonomous practitioner. Subsequent rounds prioritized the list of knowledge and skills, and the core leadership group organized knowledge and skills into global competencies and subcompetencies. Results: The first Delphi round yielded 61 POCUS areas of knowledge and skills considered important for PEM fellow learning. After two subsequent Delphi rounds, the list of POCUS knowledge and skills was narrowed to 38 items that addressed elements of six global competencies. The core leadership group then revised items into subcompetencies and categorized them under global competencies, developing a curriculum that defined the scope (depth of content) and sequence (order of teaching) of these POCUS knowledge and skill items. Conclusions: This expert, consensus‐generated POCUS curriculum provides detailed guidance for PEM fellowships to incorporate POCUS education into their programs. Our curriculum also identifies core ultrasound knowledge and skills needed by PEM fellows to perform the specific POCUS applications recommended in prior publications. [ABSTRACT FROM AUTHOR]

Protocols for the sanitation and maintenance of point‐of‐care ultrasound (US) equipment are lacking. This study introduces the CLEAR protocol (clean, locate, energize, augment supplies, and remove patient identifiers) as a tool to improve the readiness of US equipment, termed US equipment homeostasis. The state of US equipment homeostasis in the emergency department of a single academic center was investigated before and after implementing this protocol, with an improvement in outcomes. These findings demonstrate that the CLEAR protocol can improve US homeostasis. CLEAR can function as a teaching tool to promote homeostasis as well as a checklist to assess compliance. [ABSTRACT FROM AUTHOR]