Introduction to point-of-care ultrasound

POCUS: an introduction to point-of-care ultrasound technology  

In the past 10 years, point-of-care ultrasound (POCUS) has been used to aid the assessment of critically ill patients.1  As early as 2002, the National Institute of Clinical Excellence issued the use of ultrasound for CVC (central venous catheter insertion). Later, in 2008, the National Patient Safety Agency (NPSA) released a report detailing the evidence relating to POCUS and improved patient safety during pleural procedures. Soon after, the use of point-of-care ultrasound in the assessment of trauma became a mandatory component of the emergency medicine curriculum2 at the Royal College of Emergency Medicine. 

 

But what is point-of-care ultrasound exactly? What are the most innovative point-of-care technology examples and why is POCUS becoming more and more popular? We’ll take a look in this article.

POCUS definition: what is point-of-care ultrasound? 


The term point-of-care ultrasound (POCUS) refers to portable ultrasound systems that allow the assessment of patients without requiring them to be physically present in a radiology department.3

 

In other words, a good point-of-care technology definition would be to say that POCUS covers portable ultrasound devices used in the diagnostic process to address specific pathological hypotheses, at the bedside; in an emergency care unit, or in an ambulance.

 

Many clinicians have agreed that POC ultrasound, due to its scoped capabilities, works well as a complement to physical assessment.5 The difference between traditional ultrasonography and POC ultrasound? The latter lets the doctor perform “acquisitions and interpretations of images at the point of care.”6  They can use this curated data immediately to reach a quick and reliable diagnosis that will guide the next steps in the patient’s treatment journey.

Practical examples of POCUS ultrasound-assisted assessment used in the emergency setting include:

  • eFAST: focused assessment with sonography for trauma
  • BLUE: bedside lung ultrasound in emergency
  • RADiUS: rapid assessment of dyspnea with ultrasound
  • RUSH: rapid ultrasound in shock
  • FEEL: focused echocardiography in emergency life support for cardiac arrest
  • ACES: abdominal and cardiac evaluation with sonography in shock8

Each emergency specialty will have specific ultrasound protocols and skill sets required to meet their clinical needs.9  And with the increase in adherence to POCUS, medical societies continue to publish recommendations and guidelines for the use of point-of-care ultrasound that are specifically aligned with their scope of practice. For example, the Society of Critical Care Medicine has recently released guidelines on using ultrasonography for critically ill patients.10 

 

This means that undergoing specialized training is of great importance when it comes to adhering to POC ultrasound effectively and safely. That’s why Philips has created, readily available, courses and quick guides that are procedure-specific and authored by physician experts.

Benefits of POCUS: point-of-care technology examples 


Though the existence of varied training pathways points to a lack of a standardized and centralized curriculum around POCUS ultrasound, this emerging field continues to expand rapidly. Evidence shows that POCUS can undeniably improve “traditional examination techniques in the diagnosis and management” of critically ill patients. 

 

Another reason for this growth is that point-of-care ultrasound technology is constantly evolving and adapting to provide the support clinicians need.  


Case studies have shown that POCUS can:

Improve diagnostic accuracy 

Reduce the time taken to reach diagnosis 11

Improve patient safety 12

Decrease complication rates.13

 

Technology has evolved so that practitioners can make informed decisions about patient care management and diagnoses quickly, no matter where the patient is.

Innovation has allowed ultrasound systems to be uniquely simplified, so that scans can be performed faster without compromising image quality and accuracy. A good example of this is Philips Sparq  for critical care, which has automation features capable of identifying tissue type and to continuously adjust image gain while scanning, saving invaluable time. The equipment also benefits from needle visualization, a needle guidance technology, which allows for safer procedures.14

 

Smaller handheld devices, such as Lumify with Reacts, the first integrated tele-ultrasound, have taken portability, accessibility and high-quality image results to the next level. The integrated platform allows professionals to collaborate, real-time, regardless of geographical location. The benefits? With quick and easy collaboration, diagnosis can be reached with more confidence – especially helpful for trainees seeking further expert guidance. Recent news already demonstrates the impact Lumify with Reacts has had in remote areas of countries like Kenya and the Dominican Republic, where access to care can be limited.  

 

As more and more professionals become adept to point-of-care technology, it’s likely that in the near future, educational committees worldwide will not only classify POC ultrasound as mandatory but will also provide ways through which point-of-care ultrasound can be seamlessly integrated into the medical curricula in a standardized form. 15 This is particularly relevant to the prevention and control of infection  during emergency procedures where point-of-care ultrasound has become an essential aid. With training consensus and hospitals’ adherence to this technology, patients can continue to experience the benefits of point-of-care ultrasound.

1www.ncbi.nlm.nih.gov/pmc/articles/PMC6334078/

2Ibid.

3www.ncbi.nlm.nih.gov/pmc/articles/PMC6360013/

4Ibid.

5cardiovascularultrasound.biomedcentral.com/articles/10.1186/s12947-018-0132-0

6www.ncbi.nlm.nih.gov/pmc/articles/PMC6360013/

7Ibid.

8www.ncbi.nlm.nih.gov/pubmed/26034912

9onlinelibrary.wiley.com/doi/full/10.1002/ajum.12129

10cardiovascularultrasound.biomedcentral.com/articles/10.1186/s12947-018-0132-0

11www.ncbi.nlm.nih.gov/pmc/articles/PMC6334078/

onlinelibrary.wiley.com/doi/full/10.1002/ajum.12129

12Ibid.

13www.ncbi.nlm.nih.gov/pubmed/22934870

14www.ncbi.nlm.nih.gov/pmc/articles/PMC6334078/

Sources

  • cardiovascularultrasound.biomedcentral.com/articles/10.1186/s12947-018-0132-0
  • www.ncbi.nlm.nih.gov/pmc/articles/PMC6360013/
  • www.ncbi.nlm.nih.gov/pubmed/26034912
  • cardiovascularultrasound.biomedcentral.com/articles/10.1186/s12947-018-0132-0
  • www.ncbi.nlm.nih.gov/pmc/articles/PMC6334078/ 
  • onlinelibrary.wiley.com/doi/full/10.1002/ajum.12129

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