Point of care ultrasound: a clinical decision support tool for COVID-19

Abstract

The COVID-19 global pandemic has overwhelmed health services with large numbers of patients presenting to hospital, requiring immediate triage and diagnosis. Complications include acute respiratory distress syndrome, myocarditis, septic shock, and multiple organ failure. Point of care ultrasound is recommended for critical care triage and monitoring in COVID-19 by specialist critical care societies, however current guidance has mainly been published in webinar format, not a comprehensive review. Important limitations of point of care ultrasound include inter-rater variability and subjectivity in interpretation of imaging findings, as well as infection control concerns. A practical approach to clinical integration of point of care ultrasound findings in COVID-19 patients is presented to enhance consistency in critical care decision making, and relevant infection control guidelines and operator precautions are discussed, based on a narrative review of the literature.

Management of circulatory shock and hypotension

“…At the bedside, history-taking and physical examination should be supplemented by point-of-care echocardiography and lung ultrasonography (Table II). (4) Owing to the possibility of diagnostic uncertainty, repeated evaluation should be performed.…”