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But even in our small hospitals, availability of ultrasound is usually not the issue. It's the willingness of the operator to use it.

No and yes. Just because Ultrasound is available, doesn't mean it's performed and read expeditiously. It's usually a minimum of 45 minutes from order to study to read and that's on the hyper efficient side. For many studies (dvt, ocular, soft tissue for abscess or foreign body), it takes longer to figure out how to archive the images than to do the study!

The extra steps in the workflow is why alot of phantom scanning happens. Additionally, I think youre very correct that it's the willingness of the operator. I wrote a lengthy post on a paid board about this. Were pretty pennywise pound foolish on this- no matter how optimized the health system, no way you can order, perform, and read a soft tissue study study faster than I can do and save an exam! Yet this happens on the end of the would be POCUS clinician all the time. It's a bit of pin the tail on the specialist, despite pretty good evidence that POCUS can be useful for specific indications.

Alan, Ive never really enjoyed doing procedures with the IQ, the probe head is too big- give me my sonosite linear probe! When I have, I've sort of sub-optimally positioned myself with the phone on a bedside table. I've seen some folks use kickstands of sorts to prop up their phone.

As for the mental barriers of utilizing POCUS, getting it into the hands of students flattens the curve a bit. And ease of saving and archiving helps. And butterflyIQ has done a masterful job of becoming an Apple-like company amongst the crowd with a cool factor to it. Not that it's a reason to do it, but many more EM residents know what the butterfly is, and next to none know about lumify, clarius, vscan, or Vave.
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