Point of care ultrasonography in the pediatric emergency department

Abstract

ImportancePoint-of-care ultrasonography (POCUS) allows to obtain real-time images to correlate with the patient’s presenting signs and symptoms. It can be used by various specialties and may be broadly divided into diagnostic and procedural applications.ObjectiveWe aimed at reviewing current knowledge on the use of POCUS in Pediatric Emergency Departments (PEDs).FindingsUS diagnostic capacity in paediatric patients with suspected pneumonia has been studied and debated whereas literature regarding the usefulness of point-of-care echocardiography in the pediatric setting is still limited. Similarly, Focused Assessment with Sonography for Trauma (FAST) has become a standard procedure in adult emergency medicine but it is still not well codified in the pediatric practice. Concerning procedural applications of POCUS we identified 4 main groups: peripheral vascular access, bladder catheterizations, identification and drainage of abnormal fluid collections and foreign body identification.Conclusions and relevanceBedside emergency ultrasound is routinely used by adult emergency physicians and in the last 10 years its application is recognized and applied in PED. Pediatric emergency physicians are encouraged to familiarize with POCUS as it is a safe technology and can be extremely helpful in performing diagnosis, managing critical situations and guiding procedures, which results in globally improving pediatric patients care.

Usefulness of Protocolized Point-of-Care Ultrasonography for Patients with Acute Renal Colic Who Visited Emergency Department: A Randomized Controlled Study

“…In recent decades, point-of-care ultrasonography (POCUS) has been increasingly used by emergency physicians because of its easy bedside applicability without radiation exposure. Thus, POCUS can be extremely useful for the evaluation of patients with critical conditions visiting the ED [8,9]. Detecting hydronephrosis by ultrasonography is an indirect sign for ureter stone, which has a reliable sensitivity and specificity for the diagnosis of renal colic [4,10,11,12,13,14,15,16].…”

Point-of-Care Ultrasound Assists in Rapid Diagnosis of T-cell Lymphoblastic Lymphoma in a Young Boy

“…As a safe and cost-effective tool, guidelines regarding POCUS use in pediatric emergencies should be developed. As the only radiation-free imaging modality, it can help determine diagnoses and guide procedures such as chest tube placement, thoracentesis, pericardiocentesis, and peritoneal drainage [10,11].…”

“…Although the significance of POCUS in pediatric emergencies is well-supported in medical literature, the standards of practice and predictable routine use have yet to be defined [10][11][12]. T-cell LBL is a rare condition that can lead to abrupt deterioration if left untreated [13].…”

Paediatric point‐of‐care ultrasound in a resource‐limited Melanesian setting: A case series

“…Beyond the cases described, POCUS was used to assess for a wide variety of diagnoses in children including pneumonia, pleural effusions, appendicitis, ovarian torsion, and hip joint effusions. Other modalities with a high yield in PEM POCUS include the diagnosis of intussusception, and identification of soft tissue foreign bodies . In environments with a high incidence of communicable diseases, sonologists use the FASH examination to screen for suspected TB effusions, assess for oedematous states in dengue patients to guide fluid management and identify patients at high risk for deterioration, and assess the presence and degree of hepatomegaly or splenomegaly in patients with malaria.…”