What Is POCUS Used For?
July 29, 2021
As healthcare providers have sought to treat patients at the point of care, point-of-care ultrasound (POCUS) has emerged to accommodate this goal. With POCUS devices that fit right in the palm of your hand and connect to a smartphone or tablet, physicians can now expect conducting an ultrasound to be more portable and easier to access than traditional ultrasound machinery. Plus, they only cost a fraction of the price of traditional ultrasound equipment.
If you’re researching POCUS uses before investing in your own device, check out these examples of POCUS in cardiac care, anesthesia, and other use cases in emergency medicine.
What Is POCUS in Cardiac Arrest?
Point-of-care ultrasound in cardiac arrest (sometimes referred to as POCUS-CA) is a game-changer in the evaluation stages. When a patient presents with cardiac arrest, POCUS can assist with diagnosing numerous underlying causes such as:
Pneumothorax: From the absence of lung sliding to plethoric inferior vena cava (IVC), POCUS can catch many issues that may indicate pneumothorax. Consider this case study of a 21-year-old male patient with sudden-onset left-sided chest pain. By all appearances, the patient seemed clinically stable, but a cardiac POCUS exam revealed mediastinal shift and a dilated IVC before decompensation.
Hypovolemia: POCUS is an easy way to estimate volume status, helping medical professionals see if a patient has a low extracellular fluid volume (hypovolemia). With a quick scan, a physician can detect signs of hypovolemia like underfilled chambers and a flat IVC. POCUS can also guide the response assessment if fluid resuscitation is needed.
Cardiac Tamponade: Underfilled chambers, pericardial effusion, a plethoric IVC—these are all signs of possible cardiac tamponade that can be picked up with a POCUS scan. If pericardiocentesis is needed, guiding the needle to drain the excess of fluid in the IVC is a much easier process with POCUS.
POCUS can also be used to diagnose and assist with the treatment of pulmonary embolism, pump failure, acute severe valvular problems—the list goes on. While the medical community has been able to diagnose these issues with traditional imaging in the past, it’s the ability to assess these issues in the moment and make timely treatment decisions that makes POCUS so useful.
What Is POCUS in Anesthesia Care?
POCUS is proving to be especially helpful to anesthesiologists in perioperative settings. With its reliability, speed, ease of use, and accuracy, POCUS has a wide variety of applications in anesthesia, such as:
Placement and Confirmation of an Endotracheal Tube: In a recent study, 98% of the analyzed malpractice claims for delayed detection of esophageal intubation resulted in death or brain damage. Using POCUS for airway imaging over the neck can confirm proper placement in the trachea and allow medical professionals to immediately identify inadvertent esophageal intubation.
Visualization of the Cricothyroid Membrane: If emergency airway access is needed when non-invasive methods fail, an anesthesiologist or surgeon will usually attempt to perform life-saving cricothyrotomy. Unfortunately, success rates of anesthesiologists performing this procedure are low, primarily due to misplacement in the patient’s cricothyroid membrane on the neck. With POCUS, locating the cricothyroid membrane becomes much easier and more accurate with a variety of approaches such as the longitudinal “String of Pearls” or the transverse “Thyroid-Airline-Cricoid-Airline” scanning techniques.
Administering Peripheral Nerve Blocks: Having an internal visualization of a needle tip during the administration of peripheral nerve blocks is beneficial to both the anesthesiologist and patient. POCUS use during this process has proven to increase the rate of successful nerve block, decrease placement time, and decrease vascular puncture and local anesthetic systemic toxicity.
What Are Other Examples of POCUS in Emergency Medicine?
POCUS is known for its rapid diagnostic abilities—the key word here being “rapid.” Most, if not all, medical emergencies require quick evaluation and action. Many of the situations described above can be done with traditional ultrasound equipment, but it’s the speed of POCUS in these situations that makes it such an impressive tool for the medical world.
One study on the benefits of POCUS in the emergency department found countless uses, such as:
- Diagnosing appendicitis (with visualization of the appendix, POCUS had sensitivity of nearly 100% and specificity of 80–90%).
- Guiding procedures like catheter insertion, incision and drainage of abscesses, lumbar puncture, joint aspiration, etc.
- Evaluating thoracic or abdominal trauma and identifying any intrabdominal sources of bleeding.
Can I Use Point of Care Ultrasound with My iPhone, Android, or Other Smartphone?
You can use POCUS devices with most smartphones if you are using the POCUS workflow solution Exo Works™. You can:
- Connect with any DICOM-enabled ultrasound machine.
- Review and document findings in seconds.
- Automatically save to EMR and PACS for billing and storage.
- Securely distribute and access ultrasound exams through the cloud.
Even with the best POCUS device, we know imaging workflow is a huge headache for medical professionals. From improperly saved images to the nightmare of billing to securely sharing records and more, Exo Works takes that mess off your plate so you can spend more time with your patients—and have a little more time to yourself.
Would you like to see how it works? Schedule a demo with us today!
Exo is a health information and devices company modernizing medical imaging starting with making ultrasound simple and affordable for all. Exo just released Exo Works™, an intelligent and intuitive point-of-care ultrasound workflow solution that lets medical practitioners document exams in seconds and easily manage QA from anywhere. Learn more about Exo Works.