EFSUMB Clinical Practice Guidelines for Point-of-Care Ultrasound: Part One (Common Heart and Pulmonary Applications) SHORT VERSION

Jarman, Robert; Colclough, Anna; McDermott, Cian; Bøtker, Morten Thingemann; Knudsen, Lars; Harris, Tim; Albaroudi, Bilal; Albaroudi, Omar; Haddad, Mahmoud; Darke, Robert; Berry, Edward; Breslin, Tomás; Fitzpatrick, Gareth; Flanagan, Leah; Olusanya, Olusegun; Craver, Dominic; Omar, Adhnan; Simpson, Thomas; Cherian, Nishant; Dore, Martin; Prosen, Gregor; Kay, Sharon; Villén‐Villegas, Tomás; Gargani, Luna; Carley, Simon; Woo, Michael Y.; Dupriez, Florence; Hussain, Arif; Via, Gabriele; Connolly, James A.; Peck, Marcus; Melniker, Larry; Walden, Andrew; Biancardi, Mark Anthony Attard; Żmijewska-Kaczor, Olga; Lalande, Élizabeth; Geukens, Paul; McLaughlin, R; Olszynski, Paul; Hoffmann, Beatrice; Chin, Eric J.; Muhr, Christopher; Kim, Daniel; Mercieca, Andre; Shukla, Dharmesh; Hayward, Simon; Smith, Mike; Gaspari, Romolo; Smallwood, Nicholas; Pès, Philippe; Tavazzi, Guido; Corradi, Francesco; Lambert, Michael J.; Morris, C.; Trauer, Michael; Baker, Kylie; Bystrzycki, Adam; Goudie, Adrian; Liu, Rachel; Rudd, Lynne; Dietrich, Christoph F.; Jenssen, Christian; Sidhu, Paul S.

doi:10.1055/a-1882-6116

Cited by 4 publications

(5 citation statements)

References 27 publications

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“…Several international professional societies including American Society of Anesthesiologists (ASA) and American Society of Regional Anesthesia and Pain Medicine (ASRA) recognize the importance and benefits of POCUS in anesthetic practice and have established recommendations and guidelines for training and practice of perioperative POCUS [1 ▪▪ ,6,7,8,9 ▪ ]. The American Board of Anesthesiology (ABA) now tests candidates on acquisition and interpretation of POCUS images as part of objectively structured clinical exams [10].…”

Section: Perioperative Pocusmentioning

confidence: 99%

“…Brachial plexus blocks above the clavicle commonly performed in ambulatory practice can result in transient phrenic nerve palsy and diaphragmatic dysfunction [42 ▪ ]. In these patients with shortness of breath, lung POCUS can help differentiate phrenic nerve involvement from a pneumothorax [9 ▪ ].…”

Section: Lung Point Of Care Ultrasoundmentioning

confidence: 99%

“…Several guidelines and recommendations have been described for systematic lung ultrasound and are ]. In these patients with shortness of breath, lung POCUS can help differentiate phrenic nerve involvement from a pneumothorax [9 ]. Pneumothorax is diagnosed with absence of lung sliding (sliding of visceral & parietal pleura during respiration) with barcode sign on M-mode, absence of lung pulse (movement of pleura in synchrony with cardiac pulse), absence of B-lines (linear artifacts through lung fields) and the presence of lung point.…”

Section: Lung Point Of Care Ultrasoundmentioning

confidence: 99%

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HOCUS POCUS: ultrasound beyond regional anesthesia in the ambulatory setting

Arumugam,

Siddaiah,

Kalagara

2023

Current Opinion in Anaesthesiology

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Purpose of review Application of ultrasound in clinical anesthesia practice extends beyond regional anesthesia. In this review, we have discussed other point of care applications of ultrasound in perioperative care and anesthetic management with special emphasis on ambulatory practice. Recent findings Point of care ultrasound (POCUS) for anesthesiologists has gained widespread interest and popularity. Recent literature has highlighted multiple perioperative POCUS applications on various organ systems and its benefits. We have analyzed the recent available data and evidence for perioperative POCUS, its benefits and limitations in perioperative medicine. Summary Perioperative POCUS skill is a natural extension of ultrasound guided regional anesthesia. Utilizing POCUS in the perioperative period would accelerate the level of appropriate care, safety and improve outcomes in ambulatory centers. More anesthesiologists embracing POCUS would enhance patient care in a timely fashion at the ambulatory centers. POCUS in ambulatory practice can be valuable in avoiding delay or cancellation of surgeries and improving patient satisfaction.

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Section: Perioperative Pocusmentioning

confidence: 99%

Section: Lung Point Of Care Ultrasoundmentioning

confidence: 99%

Section: Lung Point Of Care Ultrasoundmentioning

confidence: 99%

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HOCUS POCUS: ultrasound beyond regional anesthesia in the ambulatory setting

Arumugam,

Siddaiah,

Kalagara

2023

Current Opinion in Anaesthesiology

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“…This has also included allied health care professions such as paramedics, nurses and physiotherapists. 12 , 13 – 15 There has been increasing move to teach PoCUS skills at an earlier stage of training, and as a result many medical schools now include PoCUS in their basic curriculum. 16 , 17 However, with an increasing number of potential PoCUS users this is likely to create a significant demand for training resources, and introducing this to already busy medical school and post-graduate training curricula will be challenging.…”

Section: Introductionmentioning

confidence: 99%

Normology: Is it Time to Rethink Point-of-Care Ultrasound Training?

Dupriez,

Jarman

2024

Journal of Medical Education and Curricular Development

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Point-of-care ultrasound (PoCUS) is increasingly being adopted by clinicians to augment their clinical examination and aid procedures. Evidence-based clinical practice guidelines now support many aspects of PoCUS practice. As a result, more and more medical schools are integrating PoCUS into their curricula, creating a significant demand for training resources. All training must ensure that trainees have the appropriate knowledge, skills and behaviour to enable the clinical integration of PoCUS. The transition from supervised to unsupervised practice is an important step in PoCUS, but should not be confused with expertise. At the start of clinical practice, confirming that something is not normal is probably enough, and trainees can subsequently improve their PoCUS diagnostic accuracy at the bedside during clinical rotations. Our hypothesis is that competency can be achieved without the need to scan patients suspected or suffering from the target pathology. This would enable most of the training to be carried out outside the clinical environment, using volunteers in planned sessions. These planned sessions will be able to accommodate a larger number of trainees and may facilitate collaboration between specialties. When patients are scanned in the clinical environment, trainees should have acquired a good level of competence beforehand. In summary, normology principles could help PoCUS trainees, at the start of their training, to acquire the knowledge, skills and behaviour necessary to achieve a level of competency allowing them to proceed to unsupervised practice. Initially confirming whether something is normal or not is enough. Nevertheless, further research should be conducted to support this concept, and its impact on PoCUS teaching in clinical practice.

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“…In short, by combining different ultrasound artifacts resulting from the interplay between fluid, air, and pleura, a diagnosis of the mentioned pathologies can be made with an accuracy of more than 90 %. B-lines have been introduced as a LUS sign of alveolar-interstitial syndrome [4,5] and a reliable marker of extravascular lung water [6,7,8,9]. B-lines are defined as vertical reverberation artifacts that arise from the pleural line, extend to the bottom of the screen, and move synchronously with lung sliding [10].…”

Section: Introductionmentioning

confidence: 99%

Lung Ultrasound as a Promising Diagnostic Tool for Primary Graft Dysfunction after Lung Transplantation

et al. 2023

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Purpose The aim of the study was to evaluate whether the quantification of B-lines via lung ultrasound after lung transplantation is feasible and correlates with the diagnosis of primary graft dysfunction. Methods Following lung transplantation, patients underwent daily lung ultrasound on postoperative days 1–3. B-lines were quantified by an ultrasound score based on the number of single and confluent B-lines per intercostal space, using a four-region protocol. The ultrasound score was correlated with the diagnosis of primary graft dysfunction. Furthermore, correlation analyses and receiver operating characteristics analyses taking into account ultrasound score, chest radiographs, and PaO2/FiO2 ratio were performed. Results A total of 32 patients (91 ultrasound measurements) were included, whereby 10 were diagnosed with primary graft dysfunction. The median B-line score was 5 [IQR: 4, 8]. There was a significant correlation between B-line score and the diagnosis of primary graft dysfunction (r = 0.59, p < 0.001). A significant correlation could also be seen between chest X-rays and primary graft dysfunction (r = 0.34, p = 0.008), but the B-line score showed superiority over chest X-rays with respect to diagnosing primary graft dysfunction in the receiver operating characteristics curves with an area under the curve value of 0.921 versus 0.708. There was a significant negative correlation between B-line score and PaO2/FiO2 ratio (r = –0.41, p < 0.001), but not between chest X-rays and PaO2/FiO2 ratio (r = –0.14, p = 0.279). Conclusion The appearance of B-lines correlated well with primary graft dysfunction and outperformed chest radiographs.

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EFSUMB Clinical Practice Guidelines for Point-of-Care Ultrasound: Part One (Common Heart and Pulmonary Applications) SHORT VERSION

Cited by 4 publications

References 27 publications

HOCUS POCUS: ultrasound beyond regional anesthesia in the ambulatory setting

HOCUS POCUS: ultrasound beyond regional anesthesia in the ambulatory setting

Normology: Is it Time to Rethink Point-of-Care Ultrasound Training?

Lung Ultrasound as a Promising Diagnostic Tool for Primary Graft Dysfunction after Lung Transplantation

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