Point-Of-Care Ultrasound (POCUS): A New Tool In Diagnostic And Invasive Procedures

Žilvinas Jucius1, Dovilė Barakauskaitė1

1Lithuanian University of Health Sciences, Academy of Medicine, Kaunas, Lithuania

Abstract

POCUS (Point-of-Care Ultrasound) is a new practice of diagnostics, also known as bedside ultrasound examination. Initially, it was used only for the diagnostics of free fluid in a patient with blunt trauma, but later it became popular in the diagnostics of other acute conditions. One of its main features is that the examination is performed by a physician that is treating the patient and raising the exact clinical question. Most often POCUS is used in emergency or intensive care units where the most important thing is to get a quick answer to a doctor’s question. In case of acute respiratory failure, the ultrasound examination may exceed the chest radiography by its sensitivity and specificity. Such pathologies are usually characterized by specific artifacts so the knowledge of specialists is essential. It has already been proven that the POCUS examination that is performed by a well-trained emergency specialist in acute conditions can be as accurate as an abdominal ultrasound performed by a diagnostic specialist. The benefits of ultrasound are increasingly emphasized in shock diagnostics as well.

Due to its wide range of applications, POCUS is also being used in certain invasive procedures. The use of ultrasound control during thoracentesis reduces the incidence of complications following this procedure. Ultrasound examination on the patient’s bedside can also assist in the differential diagnosis, thus protecting the patient from an unnecessary incision in the cases of skin and soft tissue infections.

While using POCUS, the changes can be seen and a clinical question can be answered in real-time. Patients are protected from ionizing radiation and delayed or inaccurate diagnosis. The main key to a successful ultrasound examination at the patient’s bedside is the experience of the specialist. Properly interpreted medical history, physical examination data and POCUS results may lead to appropriate treatment that is initiated in the early stages of acute conditions.

Keywords: POCUS; ultrasound; diagnostics; emergency care; intensive care