The state of critical care ultrasound training in Europe: A survey of trainers and a comparison of available accreditation programmes.

BACKGROUND: Although critical care ultrasound (CCUS) in the Intensive Care Unit has been increasing exponentially for diagnostic and therapeutic purposes, the lack of a uniform formal training structure and programme has posed the question of whether scans have been appropriately performed or reported, and whether there exists proper clinical governance to ensure a high standard of care.
METHODS: An online survey was sent to the representatives of various national intensive care societies via the European Society of Intensive Care Medicine CoBaTrICE committee. A comparison between 5 worldwide accreditation programmes was also made.
RESULTS: Twenty-seven out of 42 countries replied our survey. Five countries had a nationally accredited programme in ICM Echocardiography while six were in the process of developing one. Three countries had a CCUS-accredited programme. Most had local programmes. Transthoracic echocardiography, lung and vascular ultrasound were considered essential. Although CCUS training programmes should incorporate a combination of theoretical and practical teaching, it is not clear which is the best format. The main barriers to delivering CCUS training included a lack of formally agreed competencies, as well as a lack of trainers and time. There is also a lack of agreement between the five accreditation programmes.
CONCLUSIONS: There is a need for a well-structured and competent CCUS training program. The use of ultrasound in critical care for diagnostic and therapeutic purposes has been increasing exponentially. Once the remit of radiologists and cardiologists, point-of-care ultrasound and focused echocardiography is becoming an increasingly routine instrument for all acute specialties including intensive care medicine, despite the lack of evidence that it improves patient mortality in the ICU setting.