Description
Point-of-Care Ultrasound (POCUS) is a game-changer in emergency medicine, enabling rapid, bedside diagnosis and decision-making. It helps assess trauma, cardiac function, lung conditions, and abdominal emergencies with real-time imaging. POCUS enhances accuracy in detecting conditions like internal bleeding, pneumothorax, and shock, improving patient outcomes. Its portability and ease of use make it invaluable in critical settings, reducing reliance on traditional imaging delays. Physicians use it for guided procedures like central line placement, making interventions safer and more efficient. As technology advances, POCUS continues to revolutionize emergency and critical care medicine.
Summary Listen
- The presentation emphasizes the benefits of Point-of-Care Ultrasound (POCUS) in the Emergency Department (ED), enabling faster and more accurate diagnoses through ultrasound imaging. POCUS can be used to assess trauma, cardiac function, pulmonary conditions, vascular issues, abdominal abnormalities, OBG situations, musculoskeletal problems, and airway management.
- POCUS assists in undifferentiated shock by rapidly identifying the underlying cause, and can also guide procedures like central line placement, pericardiocentesis, and paracentesis with enhanced safety and success rates. The presentation included a trauma case scenario to illustrate POCUS application in an ED setting.
- Lung ultrasound anatomy involves the bronchi, bronchioles, and parietal/visceral pleura. Key ultrasound signs include lung sliding (movement of visceral pleura) and A-lines (horizontal artifacts). The presentation outlined three key scanning locations: R1/L1 (anterosuperior), R2/L2 (lateral), and R3/L3 (posteroinferior, also known as PLAPS).
- Normal lung ultrasound findings include the batwing sign, lung sliding, and A-lines. M-mode can be used to confirm lung sliding, showing a "seashore sign." Abnormal findings such as absent lung sliding suggest pneumothorax. The presentation also covered the curtain sign, spine sign, jellyfish sign, sinusoidal sign, and plankton sign in relation to pleural effusions and consolidated lung.
- B-lines (vertical artifacts) indicate interstitial edema or syndrome. Shred sign and hepatization of the lung are associated with lung consolidation. Loculated pleural effusions should be distinguished. The LOOP protocol provides a structured approach to lung ultrasound interpretation in the ED.
- The FAST exam (Focused Assessment with Sonography for Trauma) is a standard tool. E-FAST (Extended FAST) incorporates lung assessment. FAST indications include unstable trauma patients, abdominal/thoracic trauma, and penetrating trauma. The presentation highlighted views for the right upper quadrant, left upper quadrant, subcostal region, and pelvis.
- Recent guidelines from the American College of Physicians (ACP) recommend POCUS in cases of diagnostic uncertainty for dyspnea. The American Society of Echocardiography (ASE) emphasizes standardized cardiac POCUS protocols, and guidelines advocate for POCUS during cardiac arrest. Tele-ultrasound and increased use by nurses are also emerging trends.
Sample Certificate
About the Speakers
Dr. Siddhartha Reddy
Chief Emergency Physician, Sri Maruthi Hospitals, Tirupathi
Financial Disclosure
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