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

Abstract

Point-of-care ultrasonography (POCUS) represents a goal-directed ultrasound examination performed by clinicians directly involved in patient healthcare. POCUS has been widely used in emergency departments, where US exams allow physicians to make quick diagnoses and to recognize early life-threatening conditions which require prompt interventions. Although initially meant for the real-time evaluation of cardiovascular and respiratory pathologies, its use has been extended to a wide range of clinical applications, such as screening for deep-vein thrombosis and trauma, abdominal ultrasonography of the right upper quadrant and appendix, and guidance for invasive procedures. Moreover, recently, bedside ultrasounds have been used to evaluate the fluid balance and to guide decongestive therapy in acutely decompensated heart failure. The aim of the present review was to discuss the most common applications of POCUS in the emergency setting.

Enhancing ST-Elevation Myocardial Infarction Diagnosis and Management: The Integral Role of Echocardiography in Patients Rushed to the Cardiac Catheterization Laboratory

“…Recent developments in computerized diagnostic algorithms for ECG interpretation, particularly useful in pre-hospital environments, have assisted ECG interpretations [ 16 ]. Computer ECG measurements are instantaneous, eliminate human bias, and can accurately measure waveforms with high resolution.…”

“…The high sensitivity and specificity of the ECG in diagnosing STEMI are presupposed to avoid unnecessary and potentially dangerous invasive examinations or delaying the diagnosis of an alternative pathology to STEMI due to symptoms and ECG changes. Recent developments in computerized diagnostic algorithms for ECG interpretation, particularly useful in pre-hospital environments, have assisted ECG interpretations [16].…”

Gastrointestinal function in critically ill patients

“…Gastric ultrasound is increasingly used to assess gastric emptying in anesthesia and intensive care [33–35]. 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].…”

The role of echocardiography in pulmonary embolism for the prediction of in-hospital mortality: a retrospective study

“…However, although the ratio between the right and left ventricles [4] and the TAPSE index are the most studied signs for their prognostic value [5], the prognostic role of each sign of RV dysfunction is not clear [6][7][8]. Moreover, there is little evidence relating to the predictive capacity of other echocardiographic parameters commonly evaluated in the Emergency Department (ED) [9], such as the ejection fraction of the left ventricle and systolic pulmonary arterial pressure (sPAP) [10]. Finally, signs of RV dysfunction have a debated role in terms of sensitivity and specificity, considering high-sensitivity troponin [11,12].…”