Point-of-Care Ultrasound and the Pediatric Patient-Family Experience: A Randomized Control Study

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. However, 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: POCUS was associated with a positive patient-family experience in the pediatric ED, reducing perceived stress and anxiety. While overall experience and length of stay remained unchanged, most families in the POCUS group strongly supported its use, highlighting its potential to enhance patient-centered care and need for further research into its broader clinical integration.