2/3/2021

Reviewer: Dr. Cameron Shoraka

Topic:

Resuscitation, shock, dyspnea

Articles:

[1] Point-of-Care Multi-Organ Ultrasound Improves Diagnostic Accuracy in Adults Presenting to the Emergency Department with Acute Dyspnea

https://doi.org/10.5811/westjem.2015.11.28525

Summary: Small study (N=57) evaluating improvement of diagnostic accuracy with employment of the “triple scan” (TS). – composed of abbreviated cardiac, lung, and IVC POCUS assessment. Overall accuracy of physician diagnosis improved from 53% to 77% after TS. Limitations: small study, evaluation by verified sonographers separate from primary ER clinician, and final diagnosis based on retrospective chart review.

[2] Basic point-of-care ultrasound framework based on the airway, breathing, and circulation approach for the initial management of shock and dyspnea

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6971464/

Summary: Brief review of POCUS in acute care and trauma. Propose framework for POCUS utilization that follows the systematic ABC model typically used in the setting of shock/hypotension and dyspnea. The proposed framework includes POCUS in the evaluation of the airway for tube placement confirmation post-intubation, lung/thoracic evaluation to r/o ptx, pulmonary edema and pleural effusion, and vascular/circulatory evaluation of the heart (focused cardiac US) and IVC, abdomen (evaluation of the aorta, intraabdominal free fluid, hydronephrosis, and cholecystitis), and venous evaluation (DVT evaluation and line placement).

[3] Point of Care Ultrasound: An Overview

Summary: Expert analysis by the American college of cardiology that discussed POCUS in undifferentiated shock, cardiac arrest, trauma, as well as various common clinical presentations – including chest pain, dyspnea, and abdominal pain.