Point-of-care and lung ultrasound incorporated in daily practice

Abstract

Corresponding author: J L C Swanevelder (justiaan.swanevelder@uct.ac.za)Point-of-care ultrasound (POCUS) is a fast-growing clinical utility and is becoming an essential clinical skill for all practitioners attending to critically ill patients. Ultrasound equipment is now smaller, more affordable and readily available in clinical work areas. POCUS is performed by a non-cardiologist physician at the patient's bedside as an adjunct to the physical examination. It is easily taught, non-invasive and allows for real-time clinical information. Bedside use of ultrasound imaging aids with rapid diagnosis of severe and life-threatening pathological conditions. It can be repeated, may change clinical management, and impact on patient outcome. POCUS has a broad clinical use, including, but not limited to, focused assessed transthoracic echocardiography (FATE), lung ultrasound imaging, extended focused assessment with sonography for trauma (e-FAST), vascular access and regional blocks. It may also be extended to detect endotracheal intubation and the estimation of intracranial pressure. Assessment of cardiac pathology by POCUS, performed by a novice examiner, has been shown to compare with the gold standard of an expert. Training is paramount. The physician should know his limitations and always relate the information back to the clinical scenario and context. By incorporating POCUS as part of our armamentarium and into our daily medical practice, we might see it reach its full clinical potential, optimising patient care and improving patient outcomes.

Perioperative management of caesarean section-related haemorrhage in a maternal near-miss population: a retrospective study

“…11 The bedside use of ultrasound imaging aids with rapid diagnosis of severe and life-threatening pathological conditions that may change clinical management and impact on patient outcome. 11 This study showed that only 49.0% and 62.2% of respondents "never" or "seldom" used US whenever indicated for cardiac and lung assessments, respectively. competence required from a specialist trainee nor is there any formal logbook of US procedures required for qualification.…”

Point-of-care ultrasound for all – teaching, training and use at every opportunity

“…These other indications should also be considered in POCUS training. 5 In 2011, I indirectly asked at a SASA congress presentation publication, titled "Focused assessed transthoracic echocardiography (FATE): South Africa, 2011", how many South African practitioners use FATE (including lung ultrasound)? This short article referred to the competency levels expected from different users and the message that ultrasound assessment should be used by every anaesthesia provider.…”

Better With Ultrasound

“…Although different authors describe various specific scanning protocols for LUS, we describe here the sixpoint BLUE protocol, which is easy to perform and widely reproduced in the literature. [4][5][6][25][26][27] Although we describe BLUE points in both the paper and associated media, these points are really zones for examination, which will vary with the body habitus and anatomy of the individual patient. Figure 1A outlines the three regions on either side of the thorax for examination, the upper and lower BLUE points, and posterolateral chestjournal.org alveolar and/or pleural syndrome (PLAPS) points.…”

“…These air bronchograms, if found, help clarify the etiology of the alveolar consolidation as they point toward pneumonia. 25,26…”