Point-of-Care Abdominal Ultrasonography (POCUS) on the Way to the Right and Rapid Diagnosis

Abstract

Point-of-Care ultrasound (POCUS) is based on target ultrasound that is performed wherever a patient is being treated, and by a non-radiologist directly involved in the patient’s care. It is used either for quick diagnosis or procedural guidance. Abdominal pain is one of the most common complaints in emergency departments, and POCUS can help in the differentiation of patients who need additional diagnostic tests or hospital treatment, which eventually reduces the overall costs of health care. POCUS has high sensitivity and specificity in abdominal pathology, it can be helpful in the evaluation of biliary, intestinal, and urinary tract, and it is especially used in trauma. Additionally, the gold standard for abdominal aortic aneurysm detection, follow up and screening is precisely this diagnostic procedure. Unfortunately, the quality of ultrasound examination can be affected by the experience of the physician performing it and the patient’s body weight. There is no doubt that POCUS is being increasingly recognized, but all motivated physicians should be provided with dedicated tutors and enough time for learning. This would certainly help to implement this diagnostic method as a routine in emergency and critical care departments, and significantly shorten the time until definitive diagnosis.

The Incremental Role of Multiorgan Point-of-Care Ultrasounds in the Emergency Setting

“…The most common POCUS applications of abdominal ultrasounds include the evaluation of patients with abdominal pain or trauma [62,63]. Moreover, POCUS has also been recently used to estimate patients' fluid status, especially in those with acutely decompensated heart failure and acute kidney injury.…”

Gastrointestinal function in critically ill patients

“…Gastric ultrasound is increasingly used to assess gastric emptying in anesthesia and intensive care [33][34][35]. Some development is also reported in point-of-care ultrasound assessment of certain intestinal pathologies and abdominal venous congestion [36,37]. One study reported assessment of enteral feeding intolerance with measuring gastric antrum, colonic diameter and peristaltic frequency [38], while standardized protocol for gastrointestinal ultrasound in critical illness is still lacking [39].…”

Point of care ultrasonography as the new “Laennec Sthetoscope”

“…POCUS allows the physician to review and interpret images and make critical decisions at the point of care, and many studies have shown that POCUS protocols significantly reduced diagnostic time[ 4 ], decrease procedure complications[ 5 ], improves patient safety, increased success rates of invasive bedside procedures[ 6 ], and minimize delays in care such as time to obtain antibiotics or time to move into surgery[ 7 ].…”