Cardiovascular Point-Of-Care Ultrasonography For The Generalist

Abstract

Point of care ultrasonography (POCUS) is an adjunct to patient care that is readily available at the bedside. With its ease of training, rapid image acquisition, and minimal risk to patients, it stands out as an essential tool for patient care. Respiratory failure is one of the top indications for POCUS in clinical settings and recent data suggests good performance of point of care ultrasonography when compared to chest imaging and physician/provider assessment of acute hypoxemia in pre-hospital settings. There is a growing body of literature highlighting disparities in care for patients in resource limited or rural acute care settings. Reasons for this are numerous and multifactorial; however, certain systems can be implemented to improve institution related factors and by extension clinical outcomes such as length of time in the emergency department (ED) as well as time to diagnosis from index ED contact. Resource limited settings are constrained by limited personnel possessing the appropriate skill set to perform and interpret diagnostic imaging which is considered standard of care in most healthcare settings today and are further faced with financial constraints to acquiring personnel and equipment for performing medically necessary testing. Due to these constraints, there is delay in reaching a diagnosis with downstream consequences for patients. There has been resultant increase in POCUS research in these settings where POCUS utilization has shown good diagnostic yield as well improved patient outcomes in these settings. Given a wide range of clinical presentations, in resource limited and resource-rich settings alike, POCUS has been shown to decrease length of stay and lessen time to diagnosis in acute care settings. We present a series of cases where point of care ultrasonography has resulted in immediate diagnosis and expedited care for patients presenting to the acute care setting.