Unseen Ultrasound Scans: A Hidden Concern in Trauma Care
A recent study has shed light on a concerning issue in emergency medicine: the practice of 'ghost scans' during point-of-care ultrasound (POCUS) exams. These scans, where images are not saved, may have significant implications, as revealed in the American Journal of Emergency Medicine on October 24.
The research, led by Zachary Boivin, MD, from Yale University, uncovered a wide range of ghost scanning rates across different institutions. From over one in five to more than nine out of every ten exams, these rates highlight a persistent problem in emergency departments. Boivin and his team emphasize the need for further investigation to address this issue.
While ghost scanning is common in POCUS, it remains under-studied, especially when comparing institutions. The study focused on trauma patients who received an extended focused assessment with sonography in trauma (eFAST) exam. It included data from four Level I trauma centers with emergency medicine residencies and ultrasound fellowships.
The findings revealed a significant difference in ghost scanning rates across the sites (p < 0.001). Site 1 had a 33% ghost scanning rate, Site 2 a staggering 65.5%, Site 3 a more manageable 21.4%, and Site 4 an impressive 93.2%. Interestingly, the analysis showed a decrease in ghost scanning for positive eFAST exams at Site 2 and an increase for penetrating trauma at Site 3.
The authors suggest that workflow differences and workplace practices contribute to these variations. They propose that limited POCUS training may lead to a lack of emphasis on saving images. Additionally, the high-pressure environment of critically ill patients may result in ghost scans as other tasks take precedence.
To address this issue, the team calls for future studies to focus on quality assessment and improvement projects aimed at reducing ghost scanning rates. This research is crucial in ensuring that every POCUS exam contributes valuable data for patient care.
