Point-of-care ultrasound in Ethiopian emergency and critical care medicine: a cross-sectional study of utilization, barriers, and training priorities.

backgroundPoint-of-care ultrasound (POCUS) is a vital resuscitative, diagnostic, and procedural tool in emergency and critical care. Although integrated into Ethiopian emergency medicine training for over a decade, national data on its utilization, barriers, and training needs remain limited. This study aimed to assess current POCUS use, equipment accessibility, and educational priorities among practicing emergency and critical care physicians in Ethiopia.

methodsA cross-sectional electronic survey was distributed via Qualtrics to all emergency and critical care physicians in Ethiopia between November 2024 and January 2025. Respondents provided demographic information, POCUS utilization patterns, equipment availability, training experiences, perceived barriers, and preferences for advanced education. Descriptive statistics were used to analyze trends and identify priority needs.

results39 physicians participated (mean age 32.8 ± 3.1 years; 71.8% male). Most reported daily POCUS use (79.5%) and adequate residency training (71.8%). Equipment access was inconsistent: 43.6% had machines available > 75% of the time, while 17.9% reported < 25% availability. Barriers included broken/missing probes (35.9%), malfunctioning machines (33.3%), and prolonged repair delays, with nearly half citing repair times lasting months. Frequently used applications were Extended Focused Assessment with Sonography in Trauma (97.4%), Inferior Vena Cava assessment (94.9%), Rapid Ultrasound in Shock and Hypotension (84.6%), basic cardiac ultrasound (71.9%), and lung ultrasound (61.5%). Training priorities included advanced cardiac ultrasound (69.2%) and abdominal ultrasound in emergency (64.1%). Mismatch and quadrant analyses demonstrated mature integration of core resuscitative applications and unmet training needs for advanced cardiac, abdominal, and procedural POCUS. Nearly 90% supported establishing an in-country POCUS fellowship, with most favoring a 12‑month program.

conclusionEthiopian emergency and critical care physicians report high POCUS utilization and recognize its essential role in clinical care. However, significant equipment shortages and strong demand for advanced training underscore the need for national strategies to standardize POCUS education, expand faculty capacity, and strengthen equipment support. This assessment informs considerations for developing a structured fellowship and advancing POCUS integration within Ethiopia’s emergency and critical care practice.