The use of point-of-care ultrasounds (POCUS) in the medical community has revolutionized the way in which doctors and paramedics diagnose patients since the 1990s. If patients are experiencing symptoms like chest or abdominal pain, it can be difficult to diagnose and potentially harmful to move them to another space. This can result in wasted time and potentially increase harm to the patient. However, POCUS gives medical professionals valuable information on any concerning abnormalities quickly so they can determine what the patient needs in real-time and give them immediate care. According to one study, POCUS helped reduce the rates of pneumothorax in patients from 18% to 3%. This data is reproduced throughout several studies indicating that POCUS is reliable, precise, and beneficial for diagnosing patients.

POCUS can help better assist patients in ensuring they get the best care available. Joshua W. Russell, Editor-in-chief of The Journal of Urgent Care Medicine, states that POCUS “added limitless objective data to something which is inherently subjective.” In this blog, we will discuss what POCUS means and how it works, as well as its benefits.

What Is Point-of-Care Ultrasound?

Point-of-care ultrasound refers to the use of an ultrasound by a medical professional in any setting, such as a hospital, the home of the patient, or an ambulance. The use of POCUS in different locations is achieved by using a portable ultrasound device that can easily travel with a doctor or EMT. It empowers medical professionals to use non-invasive, efficient techniques to speed up diagnoses and better treat patients. This gives medical personnel the ability to check for any internal concerns on the spot without having to transport the patient to a stationary ultrasound machine. Because POCUS is a non-invasive imaging test, it allows physicians to see what is happening with a patient without making any incisions.

When Do You Use POCUS?

When you hear the word “ultrasound,” some might automatically jump to pregnancy check-ups, but POCUS in internal medicine can actually be used for many diagnostic examinations. So, what is POCUS used for? Many times, any internal checks—whether it’s an emergency or standard procedure—can be completed with a POCUS device. Here are a few instances/examples:

• An extension of physical exams used to determine or confirm any diagnoses produced by the physical examination itself.
• A procedural examination to locate any concerning issues or conclude the best place to perform a procedure such as inserting a needle.
• A diagnostic exam used to clarify any medical condition that cannot be determined by a physical exam, including pregnancy.
• A multi-organ scan to look at multiple areas of the body and discover any abnormalities like fluids or heart conditions, among others.

Ultimately, POCUS can help medical professionals determine what might be wrong with a patient to provide them with the best medical care.

Does POCUS Improve Patient Outcomes?

Due to their ability to diagnose patients, point-of-care ultrasounds are incredibly useful at decreasing negative outcomes. One study found that POCUS has “the potential to reduce or prevent [morbidity and mortality] in 45% of cases in which it was not used.” That means that if POCUS is used to diagnose, the patient has a higher likelihood of survival while also decreasing the possibility of misdiagnosis. Additionally, POCUS lowers the needs for multiple visits, which can reduce the amount of time and money it takes to receive a diagnosis. It can also reduce complications and improve safety associated with other “pleural procedures.” With access to POCUS results instantaneously, Exo Works™ helps medical professionals collaborate and formulate a diagnosis, eliminating unnecessary complications.

What Can POCUS Diagnose?

Beyond the uses for a POCUS exam, its versatility gives trained professionals the ability to diagnose and treat many different conditions. But what can an ultrasound detect? To better understand why the POCUS meaning in medical terms is important, we’ve listed several diagnoses it can help detect. According to the American College of Cardiology, POCUS can help diagnose:

• Undifferentiated shock
  To identify the cause of shock and help patients quickly, POCUS helps medical professionals determine which type of major shock a patient is experiencing accurately. These include:

  • Distributive shock: The body can’t get enough blood to the heart, brain, and kidneys.
  • Cardiogenic shock: Suddenly onset condition where the body can’t pump enough blood.
  • Hypovolemic shock: There is blood or other fluid loss that prevents the heart from pumping blood to the body.
  • Obstructive shock: A blockage of blood to organs.

Often this exam looks for the presence of fluid in multiple organs of the body to determine whether or not the patient is in a state of shock. One study indicates clinicians can more accurately diagnose patients using POCUS in an average of a six-minute procedure.

• Cardiac arrest
  As an increasingly common diagnostic tool during cardiac resuscitation, POCUS proves helpful when determining the cause of:

  • Tension pneumothorax: Air is trapped outside of the lungs below the rib cage.
  • Cardiac tamponade: Extra fluid is built up around the heart.
  • Pulmonary embolism: A blood clot in a blood vessel that has traveled to a lung artery and blocked the flow of blood.

The use of ultrasound to observe the activity of the heart as a predictor of death in cardiac arrest patients has been studied in several clinical investigations. The review of these studies indicates that POCUS used for cardiac arrest is a valuable tool, as long as resuscitation is not interrupted, by identifying reversible causes.

• Trauma
  Using POCUS to identify bodily trauma has been a progressively common practice. POCUS trauma detection is mainly used for:

  • Intraperitoneal hemorrhage: Bleeding within the tissue that lines your abdominal walls and covers most organs.
  • Pericardial tamponade: Fluid—often blood—that fills the sac/membrane around the heart.
  • Pneumothorax/hemothorax: A collapsed lung resulting in blood within the cavity.

Physicians and paramedics often use the FAST method (focused assessment with sonography in trauma) to determine trauma during a POCUS exam. Using POCUS for trauma is incredibly effective with low rates of false-positive or false-negative.

• Chest pain
  Another use for POCUS is to identify the causes of chest pain. Detecting these conditions are a priority for practitioners, as chest pain can stem from very serious causes. In this instance, POCUS can be used to detect:

  • Acute coronary syndrome: Blood flow to the heart is suddenly reduced.
  • Aortic dissection: The aorta, the body’s main artery, is torn in the inner layer.
  • Pulmonary embolism: A blood clot in a blood vessel that has traveled to a lung artery and blocked the flow of blood.
  • Pericardial effusion: The sac/membrane around the heart is filled with too much fluid.

POCUS for chest pain is very accurate at detecting where a patient’s symptoms stem from. In fact, one study tested 128 patients for chest pain and POCUS correctly identified 100% of the causes of symptoms.

• Dyspnea
  When a patient is displaying labored or difficult breathing symptoms, POCUS can help determine whether or not it is caused by the heart or lungs. The American Family Physician Journal states some of the individual diagnoses for Dyspnea include:

  • Congestive heart failure: Heart failure over a long period of time.
  • Coronary artery disease: Heart has difficulty supplying the heart with enough blood.
  • Cardiomyopathy: Heart disease decreases the ability to pump blood .
  • COPD: Blockage of airflow to the lungs.
  • Asthma: Airways narrow and swell.
  • Chronic pulmonary emboli: Chronic pulmonary embolism (blood clot in the lungs).

• Abdominal pain
  Abdominal pain requires immediate medical attention and has several possible diagnoses. The World Journal of Emergency Surgery notes POCUS being used to determine:

  • Acute appendicitis: infection of the appendix.
  • Epiploic appendagitis: blood flow is restricted to fat resting above the colon.
  • Acute diverticulitis: inflammation or perforation of colonic diverticulum.
  • Pseudomembranous colitis: inflammation or swelling of the colon due to Clostridioides difficile (C difficile) bacteria.
  • Intestinal tuberculosis: infection of the tissue that lines your abdominal walls and caused by Mycobacterium tuberculosis.
  • Crohn’s disease: inflammation of the digestion tract.
  • Colonic tumors: growths (polyps)—often cancerous—within the colon.

Why Are the Ultrasound Results Important?

It’s simple: POCUS results are instantaneous and allow physicians to diagnose previously ambiguous symptoms, like abdominal or chest pain. Because of this, the ultrasound results almost certainly impact the treatment a patient receives, how quickly they receive it, and ultimately the outcome of their condition. Since it has the ability to test for so many conditions, the results of POCUS often give solid answers to any unknowns and can influence the diagnoses physicians make. As we discussed, the reliability of POCUS should not be understated and is a trustworthy indicator of certain medical conditions.

Easy POCUS Results in One Place

At Exo we envision a future healthcare system that isn't constrained by hospital walls, where physicians can get answers quickly with an instant window into their patient's condition by using ultrasound. With Exo Works™, our POCUS workflow designed to facilitate speed and simplicity, you can cut out the chaos and focus on your patients with an all-in-one solution. Visit our website today for more information on how Exo can help you with your POCUS needs.