Confidence and use of physical examination and point-of-care ultrasonography for detection of abdominal or pleural free fluid. A cross-sectional survey

Article Article scientifique Article Confidence and use of physical examination and point-of-care ultrasonography for detection of abdominal or pleural free fluid. A cross-sectional survey eng 2021-06-20 2022-01 author Leidi Antonio Siro Gabriele 0000-0002-3934-0104 910614 author Saudan Antoine 824258 author Soret Guillaume 669645 author Rouyer Frédéric 885902 author Marti Christophe Alberic 97449 author Stirnemann Jérôme 793435 author Reny Jean-Luc 0000-0002-7528-7363 704339 author Grosgurin Olivier 503200 113-122 10.1007/s11739-021-02781-1 34148178 1828-0447 PMC8214715 https://link.springer.com/10.1007/s11739-021-02781-1 Physical examination (PE) has always been a corner stone of medical practice. The recent advances in imaging and fading of doctors' ability in performing it, however, raised doubts on PE usefulness. Point-of-care ultrasonography (POCUS) is gaining ground in medicine with the detection of free fluids being one of its main applications. To estimate physicians' confidence and use of PE and POCUS for the detection of abdominal or pleural free fluid, we conducted a cross-sectional survey. In all, 246 internal and emergency medicine physicians answered to the survey (197 in-hospital physicians and 49 general practitioners; response rate 28.5%). Almost all declared to perform PE in case of suspected ascites or pleural effusion (88% and 90%, respectively). The highest rates of confidence were observed in conventional PE signs (91% for diminished breath sounds, 80% for dullness to thorax percussion, and 66% for abdominal flank dullness). For the remaining signs, rates of confidence were less than 53%. Physicians with > 15 years of experience and POCUS-naïve doctors reported higher confidence in PE. Most of emergency and almost half of internal medicine physicians (78% and 44%, respectively) attended a structured POCUS course. POCUS use was higher among trained physicians for both ascites (84% vs 50%, p < 0.001) and pleural effusion (80% vs 34%, p < 0.001). Similarly, higher POCUS use was observed in younger physicians. In conclusion, PE is frequently performed and rates of confidence are low for most PE signs, especially among young doctors and POCUS users. This detailed inventory suggests an ongoing shift towards POCUS integration in clinical practice. Ascites Free fluid POCUS Physical examination Pleural effusion Ultrasonography Dewey 616 Dewey 617 56 Département de médecine 221 63 Département d'anesthésiologie, pharmacologie, soins intensifs et urgences 229 false 319 Groupe Perrier Arnaud (Médecine interne générale, de réhabilitation et de gériatrie) 585 11 Plaquettes et antithrombotiques 13 Internal and emergency medicine 17 1 b2ea88cc-b02d-40aa-9a6b-6c6d251460de Article (Published version) Public Article-scientifique-from-unpaywall.pdf 602576 application/pdf CC BY openAccess Faculté de médecine / Section de médecine clinique / Département de médecine Faculté de médecine / Section de médecine clinique / Département d'anesthésiologie, pharmacologie, soins intensifs et urgences

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Confidence and use of physical examination and point-of-care ultrasonography for detection of abdominal or pleural free fluid. A cross-sectional survey	Internal and emergency medicine			2022	215	136

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Saudan, Antoine