Article Tags: POCUS

Point of Care Ultrasound for Diagnosis and Management in Heart Failure: A Targeted Literature Review 

Sabina Yampolsky, BSE; Alan Kwan, MD; Susan Cheng, MD; Ilan Kedan, MD MPH – Cardiac point of care ultrasound (POCUS) has shown increasing utility as a tool for diagnosing and managing heart failure (HF). Within cardiology, intravascular volume assessment leveraging visualization of the inferior vena cava (IVC) is a central aspect of care, as IVC size correlates with central venous pressure. This targeted literature review aimed to examine the existing literature assessing the use of POCUS in diagnosis and management of HF patients utilizing POCUS-based IVC measurement either alone or in combination with secondary methods.

The Use of Point of Care Ultrasound in Diagnosis of Peritonsillar Abscess

Brian Kohen; Melanie Perez; Jheanelle McKay; Rolando Zamora; Curtis Xu – The use of point of care ultrasound (POCUS) for diagnosis and treatment of peritonsillar abscess (PTA) is increasing [1]. Proven advantages include improved diagnostic accuracy and treatment success rates as well as decreased otolaryngology consultation, computed tomography (CT) usage, return visits to the emergency department (ED), and length of stay [1]. We present a case of a patient with a PTA that was diagnosed and successfully treated utilizing POCUS, avoiding the need for otolaryngology consultation and CT.

The Importance of Serial POCUS Exams – Dual Pathologies in Play

Rahul Nair; Jonathan Zuo; Ariel L. Shiloh – Serial point of care ultrasound (POCUS) exams are essential to assess acute pericardial effusions which can rapidly evolve into cardiac tamponade. A typical presentation includes dyspnea, tachycardia, and chest pain. Importantly, serial cardiac exams in such high-risk patients can detect other concurrent pathologies. We present an unusual case of a patient who initially presented with an acute circumferential pericardial effusion and upon serial POCUS exams developed an unexpected Takotsubo cardiomyopathy in the setting of cardiac tamponade.

Role of POCUS in Assessing an Acute Aortic Thrombus

Zachary Boivin; Emily Mensel; Trent She – A 67-year-old female patient with a past medical history of hypertension presented to the emergency department (ED) with abdominal pain. She reported intermittent palpitations for the past three months, fevers for one week, and a recent admission three days prior for a pleural effusion and atrial fibrillation.

Can Untrained Patients Perform Their Own Skin and Soft Tissue Ultrasound Examination by Teleguidance?

Ammar Saati; Arthur Au; Aditi U. Joshi; Rebecca Davis; Frances Mae West; Resa E. Lewiss – The SARS-CoV-2 pandemic accelerated the use of telehealth with consumer adoption increasing from 11% in 2019 to 46% in 2020 [1,2]. A telehealth visit often replaced an in-person office visit for infection control and safety to the patient and healthcare team. Telehealth, the use of technology for remote medical encounters, can be an efficient way to connect doctor and patient synchronously or asynchronously. “Store and forward,” a form of asynchronous telemedicine utilizes uploaded pictures by patients for evaluation by a clinician. This aids the patient evaluation and improves the diagnostic capacity of a virtual examination.

Brain Point of Care Ultrasound in Young Children Receiving Computed Tomography in the Emergency Department: A Proof of Concept Study

Stephanie R. Davenport; Nadya Ben Fadel; Jorge Davila; Nick Barrowman; Vid Bijelic; Allan E. Shefrin – Over the last 15 years, point of care ultrasound (POCUS) has emerged as one of the most important and most utilized tools in pediatric emergency medicine (PEM) [1,2]. What was initially used as a screening tool in the assessment of major traumas to help determine the requirements for further investigation or management is now used in over 40 clinical applications including the assessment of intra-abdominal hemorrhage, cardiac views to assess function and fluid, the identification of testicular torsion and the evaluation of skull fractures [1], to list a few.

Prevalence of Phantom Scanning in Cardiac Arrest and Trauma Resuscitations: The Scary Truth

Zachary Boivin; Curtis Xu; Donias Doko; Meghan Kelly Herbst; Trent She – The prevalence of phantom scanning, or point of care ultrasound (POCUS) performed without saving images, has not been well studied. Phantom scanning can negatively affect patient care, reduce billed revenue, and can increase medicolegal liability. We sought to quantify and compare the prevalence of phantom scanning among emergency department (ED) cardiac arrests and trauma resuscitations.

Venous Excess Ultrasound (VExUS) Grading to Assess Perioperative Fluid Status for Noncardiac Surgeries: a Prospective Observational Pilot Study

Justin C. Magin; Jacob R. Wrobel; Xinming An; Jacob Acton; Alexander Doyal; Shawn Jia; James C. Krakowski; Jay Schoenherr; Ricardo Serrano; David Flynn; Duncan McLean; Stuart A. Grant – Perioperative fluid administration impacts the rate of complications following surgery. VExUS grading system is a standardized point of care ultrasound (POCUS)-based, comprehensive method to assess volume status. VExUS could serve as a tool to guide fluid management, if validated perioperatively. The primary aim was to assess the success rate of obtaining required windows for VExUS grading , as well as the feasibility within a perioperative setting among noncardiac surgery. Further, this study describes the incidence of perioperative venous congestion and associations with 30-day postoperative complications.

Exploring the Applicability of Pre-Anesthetic Cardiac POCUS in Unexpected Conditions: Could it be Helpful?

Rodolfo C. Sabogal – Formal preoperative echocardiography has traditionally been recommended when there is substantial cardiovascular disease without recent follow up, unexplained dyspnea, a functional class less than 4 METS or a Duke Activity Status Index less than 34. However, it is important to note that certain patients may present with a variety of cardiac abnormalities due to their preexisting condition or multiple treatments, and these individuals warrant consideration. The objective of pre-anesthetic cardiac POCUS is to provide clinical information in a timely manner.