Point-of-Care Ultrasound in the Emergency Department

Point-of-Care Ultrasound in the Emergency Department Ultrasound technology has revolutionized the medical industry and provided physicians with the ability to visualize internal tissue and organs in real time. Advancements and changing trends in medical technology have also seen smaller and more affordable ultrasound machines cropping up in emergency departments everywhere. 

These types of equipment can be used by professionals who aren’t necessarily radiologists or cardiologists. This can speed up diagnosis and the delivery of treatment while lessening the reliance on these specialists.

Point-of-care ultrasonography (POCUS) allows nurse practitioners (NPs) or physician assistants (PAs) in the emergency department to acquire, interpret, and clinically integrate ultrasonographic imaging on an immediate basis. It is not limited to a specific protocol, specialty, or organ system, and can be performed by the attending physician or advanced practice providers (APPs) rather than a cardiologist or radiologist.

Integrating point-of-care ultrasound in the emergency department can thus transform how medical emergencies are approached and dealt with. Let’s explore how emergency med PA, emergency nurse practitioners (ENPs) or acute care nurse practitioners (ACNPs) can be taught to use this technology and what the benefits of point-of-care ultrasound in the emergency department are.

What Does Point-Of-Care Ultrasound in the Emergency Department Entail?

Point-of-care ultrasonography is highly advanced sonography that’s performed at the point of care — meaning at the patient’s bedside by the attending physician, NP or PA. It is a widely used diagnostic tool that is especially beneficial for emergency medical situations as it allows primary caregivers to perform examinations more promptly.

Since physicians or APPs can conduct the ultrasound themselves, it is possible to bypass the need for a specialized sonographer to perform the examination in a separate location. This enables the immediate assessment, diagnosis, and decisions pertaining to the treatment, without requiring transportation or lengthy waiting periods before procuring imaging results.

Point-of-care ultrasound in the emergency department can be useful in several different instances such as respiratory failure cases, traumatic injury assessment via E-FAST exam, assessment of hypotensive patients via the RUSH exam, acute appendicitis, and abdominal aortic aneurysm.

What Is the Importance of Point-Of-Care Ultrasound in the Emergency Department?

Point-of-care ultrasounds are useful to medical professionals and patients for several reasons:

  • Reduces time taken to understand and diagnose a problem, thereby making medical decisions easier and more prompt. This allows a patient to be treated faster.
  • Offers accurate and immediate images of the internal organs and tissues of a patient without requiring a complete scan
  • Eliminates the need to transport the patient to a specialty clinic and reduces lengthy waiting periods for scan and imaging results
  • Allows non-cardiologist or non-radiologist medical practitioners to perform a sonography scan thereby reducing the need for specialists to be present for emergencies, making the emergency department more effective and efficient
  • Can be more cost-effective as POCUS equipment is affordable, readily available, and more portable, thereby reducing the need for full-fledged sonography machines to be added to emergency medical vehicles
  • Ensures that patients receive appropriate urgent care by immediately providing medical professionals with an accurate understanding of the problem

POCUS equipment has several applications and can help with issues pertaining to the cardiovascular system, respiratory system, digestive system, and reproductive system. It is thus very relevant for emergency departments to have so that they can be effective, efficient, and equipped to handle all kinds of emergencies. 

Moreover, it offers high utility value and can also be used in daily clinical practice.

Importance of Training for Point-Of-Care Ultrasound in the Emergency Department

Initially used in clinical settings during the early 2000s, the prevalence of POCUS has only grown over the last two decades. It is expected to become even more medically relevant in the coming years.

Point-of-care ultrasonography is a valuable tool that augments decision-making as it enables emergency room practitioners to perform and interpret ultrasound studies at the point of care. Robust POCUS training can ensure that practitioners meet the standards for medical credentialing and decision-making, thereby enhancing patient safety and optimizing their ability to provide emergency treatment.

Without proper training, the use of a handheld ultrasound system may lead to inaccurate information. Therefore, professionals assigned to the emergency department must undergo proper training for point-of-care ultrasonography. This will enable them to perform sonographies for accurate data and imaging, interpret the available information, and make informed decisions so that patients receive optimum care.

The main areas that must be assessed in order to determine a practitioner’s level of competence when it comes to POCUS include:

  • Image acquisition
  • Image interpretation
  • Clinical integrations in practice situations

Training and testing in these areas can help medical organizations or institutions determine how competent their medical emergency department teams are in administering and utilizing POCUS. 

With the right training, point-of-care ultrasounds can be used as an extension of physical exams in emergency situations. By embracing POCUS, the medical industry can enhance the quality of care they provide their patients and their overall productivity. 

It is possible for POCUS to be a part of the educational training for NPs and PAs. Institutions can also include it as part of their training programs. This will ensure that their delivery of emergency care is effective while helping them leverage the latest technology to make informed decisions in crucial situations. 

Conclusion

Using point-of-care ultrasound in the emergency department can make emergency nurse practitioners and other medical professionals more competent when dealing with emergency situations. An emergency ultrasound course can provide them with the required knowledge to use a POCUS machine which can be highly advantageous

With the help of these ultrasound courses, emergency medicine can be made more effective and efficient as professionals can promptly and accurately diagnose and treat patients who are in need of urgent, life-saving medical care.

Resources

Leidi,A. Rouyer, F. Marti, C. Reny, J, Grosgurin, O. Point of care ultrasonography from the emergency department to the internal medicine ward: current trends and perspectives. Emerg Med. 2020 ;15(3):395-408
Hashim, A. Junaid, M. Ullah, I. Sohaib, M. Siddiqi, H. Yousaf, Z. The utility of point of care ultrasonography (POCUS) . Ann Med Surg. 2021; 71: 102982.
Lenghong, K. Woon, L. Tiamkao, S. Bhudhisawasdi, V. Apiratwarakul, K. Integrating Point of Care Ultrasound Education into Clinical Practice at the Emergency Department. Tomography. 2022; 8(2): 1052–1059.
Smallwood, N. Dachsel, M. Point-of-care ultrasound (POCUS): unnecessary gadgetry or evidence-based medicine?. Clin Med. 2018; 18(3): 219–224
Lee, L. DeCara, J. Point-of-Care Ultrasound. Curr Cardiol Rep. 2020; 22(11): 149
Carrera, K. Hassen, G. Camacho-Leon, G. Rossitto, F. Martinez, F. Debele, T. The Benefits and Barriers of Using Point-of-Care Ultrasound in Primary Healthcare in the United States. Cureus. 2022. ; 14(8): e28373.
Khanyi, H. Naicker, B. The use of point-of-care ultrasound in a regional emergency department in KwaZulu-Natal, South Africa. S Afr Fam Pract (2004). 2021 23;63(1):e1-e6
Lanspa, M. Fox, S. Sohn, J. Dugar, S. Definitive Advantages of Point-of-Care Ultrasound: A Case Series. CASE. 2022; 6(6): 293–298
Fraleigh, C. Duff, E. Point-of-care ultrasound. Nurse Pract. 2022; 47(8): 14–20.

Read all articles in Emergency Procedures, FAST Exam, Featured, medical procedures, RUSH Exam
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