Center Survey
Center identification
Type of structure
☐ University hospital
☐ General hospital
☐ Private hospital
☐ Military hospital
Type of intensive care unit
☐ Cardiovascular intensive care unit
☐ Medical intensive care unit
☐ Polyvalent intensive care unit
☐ Surgery intensive care unit
☐ Pediatric intensive care unit
☐ Neonatal intensive care unit
☐ Other
Number of intensive care unit beds
Ultrasound machine
☐A single machine in my unit
☐ Severalmachines in my unit
☐ Shared with another unit
☐ Lent by another unit
☐ No
If several ultrasound machine: how many?
Type of ultrasound machine
☐ Mini
☐ Compact
☐ Cardiology type
☐ Other
What is the type of probe?
☐ Cardiac
☐ Abdominal convex
☐ Micro-convex
☐ Linear high frequency
☐ TEE
☐ Other
Existence of a written protocol probes and US scan disinfection
☐ Yes
☐ No
☐ I do not know
Number of board-certified doctor
Admission SAPS II
Mean length of hospital stay (adult)
Mean length oh hospital stay (pediatric patient)
How often are the following ultrasound performed in your unit?
Use of ultrasound for central venous catheter placement
☐ Systematic
☐ > 50%
☐ < 50%
☐ Never
If use of ultrasound for central venous catheter placement
☐ Majority of guidance ultrasound
☐ Majority of landmark technique
☐ Systematic guidance ultrasound
Do you use ultrasound for peripheral venous catheter placement
☐ Yes
☐ No
Number of central venous catheter inserted the last 24 hours (during the study period)
Number of central venous catheter with guidance ultrasound inserted the last 24 hours
Number of arterial catheter inserted the last 24 hours
Number of arterial catheter with guidance ultrasound inserted the last 24 hours
Number of peripheral venous catheter with guidance ultrasound inserted the last 24 hours
Is the use of ultrasound was based on a management algorithm in your unit?
☐ Yes
☐ No
Patient Consent Form
POCUS for diagnostic assessment
Center identification
Operator
☐Intensivist
☐ Radiologist
☐ Cardiologist
☐Other
Board-certified operator
☐ Yes
☐ No
Practice frequency
☐ Everyday
☐ Every week
☐Every month
☐ Beginner
Age
☐ ≤15 years
☐ > 15 years
Weight
SAPS II score
PELOD score
Admission main motive
☐ Medical
☐ Surgical
☐Severe trauma
☐ Heart surgery
☐ Neurosurgery
Clinical status: mechanical ventilation
☐ Yes
☐ No
Clinical status: Pa02/Fi02<300 mmHg
☐ Yes
☐ No
Clinical status: sedation
☐ Yes
☐ No
Clinical status: Vasopressor
☐ Yes
☐ No
Patient already included in echoday
☐ Yes
☐ No
Type of ultrasound performed
☐Transthoracic echocardiography
☐ Transesophageal echocardiography
☐ Pleural ultrasound
☐ FAST
☐ Abdominal echography
☐ Transcranialdoppler
☐ Venous or arterial doppler
☐ Renaldoppler
☐ Diaphragmatic ultrasound
☐ Other
First indication
☐ Systematic realization
☐ Control of a previous ultrasound exam
☐ Diagnostic testing control
☐ Specific clinical question or clinical pathologic condition
Timing
☐ At ICU admission
☐ During hospitalization
Emergent ultrasound exam(< 1 h after the first clinical sign)
☐ Yes
☐ No
Ultrasound performed during night shift
☐ Yes
☐ No
Examination time
Quality of image
☐ Good (full visualization of structures)
☐ Average (partial vizualisation allowing assessment)
☐ Poor (no vizualisation or no possible assessment)
Impact of ultrasound exam on diagnosis
☐ Confirmation
☐ Change
☐ No information
Ultrasound-induced change in treatment
☐ New Treatment
☐ Stop Treatment
☐ Continued treatment (dependent of ultrasound exam)
☐ No change in treatment (independent of ultrasound exam)
If new therapeutic intervention
☐ Hemodynamic or medical intervention
☐ Invasive procedure
If new therapeutic intervention
☐ Fluid bolus
☐ Fluid depletion
☐ Catecholamines
☐ Pulmonary artery hypertension treatment
☐ Antibiotics
☐ Sedation
☐ Mechanical ventilation setting
☐ Anticoagulation
☐ Surgery/ interventional procedure
☐ Chest tube insertion
Need to perform additional examination
☐ Yes
☐ No
Modification of triage
☐ Continued hospitalization in the ICU
☐ Discharge from ICU
☐ No modification of patient triage
Therapeutic impact(ultrasound-induced change in treatment and/or imaging ordering and/or patient triage)
☐ Yes
☐ No
Patient Consent Form
POCUS for ultrasound guidance
Center identification
Operator
☐Intensivist
☐ Radiologist
☐ Cardiologist
☐ Nurse
☐Other
Age
☐ ≤15 years
☐ > 15 years
Weight
SAPS II
PELOD score
Exam already included in Echoday
☐ Yes
☐ No
Type of ultrasound guidance
☐ Peripheralvenousaccess
☐ Central venousaccess
☐ Arterial access
☐ Other