Impact of Point-of-Care Ultrasound on Patient-Family Experience and Behavioral Response in a Pediatric Emergency Department: A Randomized Control Survey Trial.

Abstract

BACKGROUND: Existing literature indicates that patients respond positively to point-of-care ultrasound (POCUS) across various clinical settings. However, limited research explores how patient-families perceive its use in pediatric emergency department (ED) care. Our study aims to evaluate POCUS's impact on patient experience, stress, and anxiety in the pediatric ED. METHODS: We conducted a randomized study (1:1) of pediatric patients (≤ 17 years) presenting with a clinical indication for POCUS (lung, FAST, cardiac, or soft tissue applications). Patients were assigned to either a POCUS or non-POCUS group, excluding those who were unstable or had prior POCUS evaluations. Patient-families completed pre- and post-surveys (5-point Likert scale) at triage and ED disposition. Demographic data were obtained from the electronic medical record. Statistical analyses included Chi-Square, Fisher's Exact, Wilcoxon, and sign tests (α = 0.05) to compare group responses and assess for changes in responses over time. RESULTS: A total of 200 patient-families were enrolled. The cohort was primarily English-speaking, non-Hispanic White males, with an average age of 5.16 years (SEM ±0.37). Common chief complaints included cough (34%), fever (15%), abdominal pain (14%), and shortness of breath (13%). No significant differences were observed in patient experience or ED length of stay. Sign tests indicated significant reductions in stress and anxiety within both groups from pre- to post-survey assessments [Anxiety: p < 0.0001 (POCUS), p = 0.0003 (non-POCUS); Stress: p < 0.0001 (POCUS), p < 0.0001 (non-POCUS)]. POCUS patient-families reported a significantly greater perceived importance of imaging and stated that POCUS directly alleviated their stress and anxiety. CONCLUSION: The primary outcome, magnitude of change in stress and anxiety, demonstrated significant reductions in both POCUS and non-POCUS groups. Despite similar findings within each group, families receiving POCUS reported greater perceived importance of imaging and strong support for its use, highlighting its potential to enhance patient-centered care and support further research into its optimal implementation in pediatric emergency care.