COVID-19 has caused great devastation in the past year. Multi-organ point-of-care ultrasound (PoCUS) including lung ultrasound (LUS) and focused cardiac ultrasound (FoCUS) as a clinical adjunct has played a significant role in triaging, diagnosis and medical management of COVID-19 patients. The expert panel from 27 countries and 6 continents with considerable experience of direct application of PoCUS on COVID-19 patients presents evidence-based consensus using GRADE methodology for the quality of evidence and an expedited, modified-Delphi process for the strength of expert consensus. The use of ultrasound is suggested in many clinical situations related to respiratory, cardiovascular and thromboembolic aspects of COVID-19, comparing well with other imaging modalities. The limitations due to insufficient data are highlighted as opportunities for future research.

The six-view ACES protocol is a useful adjunct to clinical examination in patients with undifferentiated hypotension in the emergency department. A prospective randomised trial or multicentre database/registry is needed to investigate the validity and impact of this protocol on the early diagnosis and management of hypotensive patients.

Toothbrushing programmes The BDA has backed new calls from NICE for oral health programmes in schools, calling on national government to support local authorities to turn the tide on an epidemic of tooth decay. NICE has recommended councils provide toothbrushing schemes in schools and nurseries in areas where children have poor oral health. Similar schemes exist in both Wales and Scotland, where devolved governments have set out dedicated oral health strategies that include outreach to early years and primary schools, and which have contributed to record breaking falls in decay. Despite progress by many local authorities , there is no equivalent programme in England. Health officials have claimed that devolution of powers to local authorities in England represents a barrier to rolling out a dedicated national programme. UPFRONT © 2 0 1 7 B r i t i s h D e n t a l A s s o c i a t i o n. A l l r i g h t s r e s e r v e d .

This executive summary will provide a brief overview of consensus statements on sonography in hypotension and cardiac arrest (SHoC) recommended by the International Federation for Emergency Medicine (IFEM) for use in emergency medicine (EM). PurposeAs point of care ultrasound (PoCUS) has become an established tool in the initial management of patients with undifferentiated hypotension and during cardiac arrest, the Ultrasound Special Interest Group (USIG) of IFEM was tasked to provide consensus guidance for use in EM that was designed to be widely implementable internationally, and which was targeted at likely etiologies as well as guiding resuscitation. The protocols were also aimed at minimizing interruption of ongoing resuscitation. A hierarchical model was proposed, to be developed by expert consensus based upon disease incidence, previously published protocols, and the medical literature. A practical checklist was to be developed, along with a standardized approach to the performance of scans based upon a "4 F" approach: fluid, form, function, filling. Consensus approachWe summarized the recorded incidence of PoCUS findings from two international multicentre prospective studies

Objectives: To evaluate non-radiologist performed emergency ultrasound for the detection of haemoperitoneum after abdominal trauma in a British accident and emergency department. Methods: Focused assessment with sonography for trauma (FAST) was performed during the primary survey on adult patients triaged to the resuscitation room with suspected abdominal injury over a 12 month period. All investigations were performed by one of three non-radiologists trained in FAST. The ultrasound findings were compared against the investigation of choice of the attending surgeon/accident and emergency physician. The patients were followed up for clinically significant events until hospital discharge or death. Results: One hundred patients who had sustained blunt abdominal trauma, were evaluated by FAST. Nine true positive scans were detected and confirmed by computed tomography, diagnostic peritoneal lavage, or laparotomy. There was one false positive in this group, giving a sensitivity of 100%, specificity 99%, and positive predictive value of 90%. Ten patients with penetrating injuries were evaluated with a sensitivity and specificity for FAST of 33% and 86% respectively. Conclusions: Emergency torso ultrasound for the detection of haemoperitoneum can be successfully performed by trained non-radiologists within a British accident and emergency system. It is an accurate and rapid investigation for blunt trauma, but the results should be interpreted with caution in penetrating injury.