Archives

Emergency Physician Performed Ultrasound-Guided Abdominal Paracentesis: A Retrospective Analysis 

Brandon M. Wubben, MD; Jad Dandashi, MD; Omar Rizvi, MD; Srikar Adhikari, MD – Emergency physicians commonly perform ultrasound-assisted abdominal paracentesis, using point of care ultrasound (POCUS) to identify ascites and select a site for needle insertion. However, ultrasound-guided paracentesis has the benefit of real-time needle visualization during the entire procedure. Our objective was to characterize the performance of emergency physician-performed ultrasound-guided paracentesis using POCUS, their ability to achieve good in-plane needle visualization, and factors associated with procedural success.

Trends in Point of Care Ultrasound Familiarity Among Undergraduate Medical Clerkship Educators 

Nilan Schnure, MD; Mahmoud Mohamed Elfadil, MD; Wilma Chan, MD MSCE; Cameron Baston, MD MSCE; Frances Shofer, PhD; Nova Panebianco, MD MPH – Despite growing use of point of care ultrasound (POCUS), there remains a paucity of data about familiarity with POCUS among educators who dictate curricular content in undergraduate medical education. This paper aims to longitudinally characterize the level of comfort and frequency of POCUS use among faculty involved in undergraduate clerkship education.

Radiology Imaging Adds Time and Diagnostic Uncertainty when Point of Care Ultrasound Demonstrates Cholecystitis 

David Cannata, BS; Callista Love, BS; Pascale Carrel, BA; Trent She, MD; Seth Lotterman, MD; Felix Pacheco, MD; Meghan Kelly Herbst, MD – Point of care ultrasound (POCUS) is specific for acute cholecystitis (AC), but surgeons request radiology imaging (RI) prior to admitting patients with POCUS-diagnosed AC. Objectives: We sought to determine the test characteristics of POCUS for AC when performed and billed by credentialed emergency physicians (EPs), the accuracy rate of RI when performed after POCUS, and the time added when RI is requested after POCUS demonstrates AC.

Best Practices for Point of Care Ultrasound: An Interdisciplinary Expert Consensus 

Brandon Oto, PA-C FCCM; Robert Baeten, PA-C FCCP; Leon Chen, DNP AGACNP-BC FCCP FAANP FCCM; Puja Dalal, MD FAAFP; Ria Dancel, MD FACP SFHM FAAP; Steven Fox, MD; Carl William Lange IV, MSBS EM-CAQ PA-C; Cameron Baston, MD MSCE FACP; Paul Bornemann, MD RMSK RPVI; Siddharth Dugar, MD FCCM FASE FCCP; Andrew Goldsmith, MD MBA; Meghan Kelly Herbst, MD FACEP; James N. Kirkpatrick, MD FASE FACC; Abhilash Koratala, MD FASN; Michael J. Lanspa, MD; Viveta Lobo, MD FACEP; Jason T Nomura, MD FACEP FAAEM FACP FAHA; Aliaksei Pustavoitau, MD MHS FCCM; Mourad H. Senussi, MD MS; Vincent L. Sorrell, MD FACP (honorary) FACC FASE FSCCT FSCMR; Frances Mae West, MD MS FACP; Aarti Sarwal, MD FNCS FAAN FCCM FASN RPNI – Despite the growing use of point of care ultrasound (POCUS) in contemporary medical practice and the existence of clinical guidelines addressing its specific applications, there remains a lack of standardization and agreement on optimal practices for several areas of POCUS use. The Society of Point of Care Ultrasound (SPOCUS) formed a working group in 2022 to establish a set of recommended best practices for POCUS, applicable to clinicians regardless of their training, specialty, resource setting, or scope of practice.

The Application of Point of Care Ultrasound to Screen for Pulmonary Hypertension: A Narrative Review 

Danny Yu Jia Ke, BSc; Melissa Tso, MB BCh BAO FRCPC; Amer M. Johri, MD MSc FRCPC FASE – Pulmonary Hypertension (PH) is a condition with several cardiopulmonary etiologies that has the potential of progressing to right heart failure without proper intervention. After a history, physical exam, and investigations, cases of suspected PH typically undergo imaging via a transthoracic echocardiogram (TTE). This is a resource-intensive procedure that is less accessible in remote communities. However, point of care ultrasound (POCUS), a portable ultrasound administered at the bedside, has potential to aid in the diagnostic process of PH.

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.

Inside the November 2023 Issue

Benjamin T. Galen – This is a very exciting time for POCUS Journal. As the world’s leading point of care ultrasound journal, we remain free for both authors and readers.  Our content brings the POCUS community together as we strive to showcase POCUS use by clinicians from a wide variety of fields in every possible clinical setting.

High Tech POCUS Education in Remote Environments: An App Review

Jeremy J. Webb; Chad Mosby; John Stadnyk; Michael Jones – In recent years, the development of hand-held devices have intrigued POCUS enthusiasts due to improved affordability, portability, and ease of use. They also provide extra functionality for image storage and transmission for remote provider-to-provider communication and review. Due to these capabilities, portable ultrasound has found its use expanded to pre-hospital, wilderness, and austere settings, where cart-based machines and other imaging modalities are not an option.

Rekindling the Relevance of Obstetrical Transvaginal POCUS: Overcoming Barriers to Ensure Patient-Centered Care

Alexis Salerno; Resa E. Lewiss – The transvaginal pelvic point of care ultrasound (POCUS) examination remains a patient-centered and relevant examination. Since 2008, emergency medicine physicians are required to learn, perform, and interpret POCUS examinations to deliver safe and patient-centered diagnostic and procedural care. Pelvic POCUS is one of these core applications in the emergency physician scope of practice. A pelvic POCUS examination seeks to answer the focused question, “Is there an intrauterine pregnancy (IUP)” and risk stratifies the patient when ectopic pregnancy is a clinical concern.

Obstetric-Focused POCUS Training for Medical Students

Koral Cohen; Jennifer Kidd; Emily Schill; Agata Kantorowska; Wendy Kinzler; Martin Chavez – Point of care ultrasound (POCUS) is rapidly expanding throughout the United States. Due to its ability to quickly and accurately diagnose and guide therapy for critical conditions, POCUS is becoming routine in many specialties, with established guidelines in fields such as emergency medicine and critical care.