The Impact of Point-of-Care Ultrasound (POCUS) Beyond the ICU: A New Study

Point-of-care ultrasound (POCUS) has long been a staple in intensive care units (ICUs) for its invaluable assistance in diagnosing and managing critically ill patients. However, its application outside of ICU settings, particularly in general hospital wards, remains underexplored. A recent study sought to fill this gap by examining the use and impact of POCUS by ICU triage teams on patients outside of the ICU.

The study was conducted at two hospitals: Stanford Hospital and Veterans Affairs Palo Alto Health System. ICU triage fellows were equipped with portable ultrasound devices and instructed to use them during consultations, rapid response alerts, and hospital code activations. They documented the reasons for ultrasound use, the views obtained, clinical impressions before and after using the ultrasound, and any subsequent clinical actions.

Key Findings

1. Reasons for Ultrasound Use: The primary reason for ICU triage team evaluations was hypotension, accounting for 53% of the cases. The primary clinical focus was cardiac assessment (53%) followed by volume status assessment (35%).
2. Ultrasound Views Obtained: The most frequently obtained ultrasound views included parasternal long axis (82%), apical four-chamber view (76%), and subcostal view (75%).
3. Impact on Clinical Impressions and Actions: In 79% of cases, pre-ultrasound clinical impressions were confirmed by the ultrasound findings. Significant clinical actions, such as fluid resuscitation and vasopressor initiation, were taken in 35% of encounters based on ultrasound results.

The study highlights the value of POCUS in non-ICU settings, demonstrating that it can effectively confirm clinical impressions and guide therapeutic decisions. Despite some limitations, such as reporting bias and incomplete data capture, the findings suggest that POCUS has significant potential in enhancing patient care in general hospital wards.

SonoSim offers a comprehensive ultrasound training ecosystem that can support critical care programs & providers in creating POCUS mastery pathways. With tools like the SonoSimulator® and online ultrasound courses, SonoSim supports practitioners as they develop and refine their ultrasound skills in a simulated, risk-free environment. This ensures that healthcare providers are well-prepared to use POCUS to effectively enhance patient care and improve outcomes, whether in an ICU or a general hospital ward.