Point-of-care ultrasound of the brain: A systematic review of competencies and training frameworks for intensivists

Abstract

Background: POCUS is increasingly in utility and application across a variety of specialities. Although several professional societies, including the European Society of Intensive Care Medicine (ESICM) have recommended focussed Neurological ultrasound be a core competency, recommendations on how best to achieve this competency are lacking. Aim: The purpose of this systematic review was to assess what best-practice and evidence-based recommendations are available to achieve competency in Neurological Point-of-care ultrasound (NeuroPOCUS). Methods: We undertook a structured systematic review of publications and studies on the training of NeuroPOCUS for intensive care. Results: Our search strategy yielded a total of 4965 publications, reduced to 3551 following de-duplication. Despite this, only 28 publications were relevant following review of title and abstract and only 12 of these on full-text review. We identified three prospective studies, four consensus statements and five publications as posters and published abstracts. Structured analysis of these revealed minimal evidence-based teaching recommendations, and significant variability in teaching method. Conclusion: Compared to other modalities of POCUS (e.g. Cardiac and Lung), NeuroPOCUS lags behind with regards to utilisation and training in the general intensive care setting. Further work is needed to establish how this technique can be effectively taught and assessed for clinical application.