Point of Care Ultrasound in acute settings – a narrative review

Abstract

Point of care ultrasound (POCUS) has become a standard assessment tool for the acute medical practitioner. Ultrasound has traditionally been the preserve of radiologists and cardiologists, however the use by practitioners outside these specialties in the treatment of acutely ill patients began in the emergency department. Patients presenting with trauma or shock were assessed looking for life threatening injuries to inform immediate management.

Over the years and more recently during the COVID-19 pandemic, numerous POCUS protocols have been developed to standardise the practice of POCUS and to guide training. However, there are pitfalls to POCUS which include cross-contamination of infection, inter and intra-observer variability, bias, and retention of skills amongst practitioners.

The use of POCUS  has increased in resource limited settings as ultrasound machines have become cheaper and more portable, however challenges remain with considerable lack of trained healthcare staff and paucity of training opportunities. This has led to a considerable variability in the practice of POCUS in these settings.

Artificial intelligence is increasingly being leveraged as a to improve image acquisition, interpretation, and POCUS training. POCUS devices are also significantly smaller, cheaper, and more portable, increasing their availability to resource poor settings. There is potential for remote training platforms to improve access to learning opportunities in resource poor countries.