Current practices and perceived barriers to the use of emergency point of care ultrasound by emergency care practitioners in Tanzania

Emergency point of care ultrasound (ePOCUS) is an essential bedside diagnostic tool that supports rapid clinical decision-making in emergency departments (EDs), and is particularly useful in limited resource settings due to its low cost. However, as many EDs in these settings are not staffed with emergency specialists, it is unclear how ePOCUS is integrated into routine use. This study aimed to assess the current practices and perceived barriers to the use of ePOCUS by emergency care practitioners in Tanzania. A cross-sectional survey using a self-administered electronic questionnaire distributed via REDCap was conducted among emergency care practitioners regularly working in public emergency departments (EDs) at secondary and tertiary level hospitals in Tanzania between 1st April and 31st May 2025. Data collected included demographics, ePOCUS training, use of ePOCUS, self-reported confidence and perceived barriers to use of ePOCUS in the ED. Descriptive statistics were used to summarize the study variables. Of 522 eligible emergency care practitioners, 378 emergency care practitioners participated, yielding a response rate of 72.4%. The median age was 30 years old (IQR 29–33). The median work experience in the ED was 2 years (IQR 1–3), and the majority of participants (77.2%) had not undertaken residency training in emergency medicine. While 74.1% reported using ePOCUS, 45.8% had received training, with only 25.4% among those trained having formal certification. The most common ePOCUS modalities performed included focused assessment sonography in Trauma (FAST) (95.7%), inferior vena cava (IVC) for volume assessment (73.9%), and lung ultrasound (70.7%). Although 86.5% perceived ePOCUS as useful, only 37% felt confident in their skills. The most commonly reported barriers to ePOCUS use were lack of training, limited availability of working ultrasound machines, inadequate administrative support and lack of incorporation of ePOCUS use into emergency care institutional or national clinical guidelines and protocols. ePOCUS is widely used by practitioners in Tanzania EDs; however, fewer than half have received training, with lack of training identified as the most frequently reported barrier. Additional reported barriers included limited equipment availability, inadequate administrative support, and lack of incorporation of ePOCUS use into emergency care institutional or national clinical guidelines and protocols which further hinder its utilization. Addressing these barriers may promote more consistent adoption and use of ePOCUS in emergency care settings in LMICs.