Clinical Use of Lung Ultrasound by Emergency and Intensive Care Physicians: A Swiss National Survey

TL;DR

This study explores how emergency and ICU physicians in Switzerland use lung ultrasound, highlighting its common applications and barriers to adoption.

Contribution

The study provides the first Swiss national survey on lung ultrasound usage, revealing disparities in training and protocol standardization.

Findings

Lung ultrasound is primarily used for evaluating dyspnea, shock, and hypoxemia.

ICU physicians use LUS more for invasive procedures compared to non-ICU physicians.

Only a minority of physicians report using standardized protocols for LUS.

Abstract

Lung ultrasound (LUS) has gained popularity in the emergency department (ED) and intensive care unit (ICU). However, little is known about its use, training, indications, and implementation barriers. Therefore, we performed a survey to evaluate the current practice of LUS among ED and ICU physicians with varying experience levels across regions in Switzerland.

A 27‐question online survey was disseminated across 108 EDs and 75 ICUs using snowball sampling via department heads.

Of all 198 participants from 183 invited departments (49.0% ED physicians, 42.3% ICU physicians, 8.7% from other specialties), 190 (95.5%) use ultrasound and 164 (82.8%) use LUS in their clinical practice. Predominantly, LUS is utilized for evaluating dyspnea (95.9%), shock (76.2%), and hypoxemia (73.5%). ICU physicians used LUS more for invasive procedures, while less experienced physicians had lower certification rates. Standardized protocols for LUS examination or documentation were reported by only 22.5% and 38.9% of responders, respectively. The main barriers identified were time constraints, lack of training opportunities, and underestimation of LUSs diagnostic value.

LUS is widely adopted and considered highly relevant by ED and ICU physicians. However, disparities in usage and proficiency were observed between ICU and non‐ICU physicians, as well as between more and less experienced practitioners. Addressing the identified training gaps and promoting standardized protocol adoption are imperative for optimizing LUSs integration into patient care.

Lung ultrasound is widely used by emergency and ICU physicians, especially for evaluating dyspnea, shock, and hypoxemia. Despite high clinical relevance, gaps in formal training and protocol standardization persist. Enhancing education and harmonizing practices is essential for optimizing LUS integration into acute care.

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