Point-of-care ultrasonography in critical care medicine: a one way directional road

Point of care ultrasonography (POCUS) is a tool that can be used at the bedside to aid in the diagnosis and treatment of critically ill patients. The ability to directly visualize physiology, pathology, and response to treatment can add valuable information in patient management particularly in time sensitive situations with acutely decompensated patients as may occur in the context of rapid response team (RRT) events. Although most of the data on POCUS to guide resuscitations has been published through emergency medicine (EM) and pre-hospital studies, the same approach can be easily adapted for in-hospital RRT events. This chapter reviews validated POCUS protocols for the assessment of hypotensive, hypoxic, or arresting patients and the ways it can be incorporated into in-hospital RRTs.

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Point-of-care ultrasonography: a practical step in the path to precision in critical care

Critical Care ◽

10.1186/s13054-017-1802-2 ◽

2017 ◽

Vol 21 (1) ◽

Cited By ~ 1

Author(s):

Gentle Sunder Shrestha

Keyword(s):

Critical Care ◽

Point Of Care ◽

Point Of Care Ultrasonography

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Development and Validation of an Assessment Tool for Competency in Critical Care Ultrasound

Journal of Graduate Medical Education ◽

10.4300/jgme-d-14-00613.1 ◽

2015 ◽

Vol 7 (4) ◽

pp. 567-573 ◽

Cited By ~ 12

Author(s):

Paru Patrawalla ◽

Lewis Ari Eisen ◽

Ariel Shiloh ◽

Brijen J. Shah ◽

Oleksandr Savenkov ◽

...

Keyword(s):

Critical Care ◽

Delphi Method ◽

Assessment Tool ◽

Point Of Care ◽

Critical Care Medicine ◽

Competency Assessment ◽

Point Of Care Ultrasound ◽

Modified Delphi Method ◽

Modified Delphi ◽

Critical Care Ultrasound

ABSTRACT Background Point-of-care ultrasound is an emerging technology in critical care medicine. Despite requirements for critical care medicine fellowship programs to demonstrate knowledge and competency in point-of-care ultrasound, tools to guide competency-based training are lacking. Objective We describe the development and validity arguments of a competency assessment tool for critical care ultrasound. Methods A modified Delphi method was used to develop behaviorally anchored checklists for 2 ultrasound applications: “Perform deep venous thrombosis study (DVT)” and “Qualify left ventricular function using parasternal long axis and parasternal short axis views (Echo).” One live rater and 1 video rater evaluated performance of 28 fellows. A second video rater evaluated a subset of 10 fellows. Validity evidence for content, response process, and internal consistency was assessed. Results An expert panel finalized checklists after 2 rounds of a modified Delphi method. The DVT checklist consisted of 13 items, including 1.00 global rating step (GRS). The Echo checklist consisted of 14 items, and included 1.00 GRS for each of 2 views. Interrater reliability evaluated with a Cohen kappa between the live and video rater was 1.00 for the DVT GRS, 0.44 for the PSLA GRS, and 0.58 for the PSSA GRS. Cronbach α was 0.85 for DVT and 0.92 for Echo. Conclusions The findings offer preliminary evidence for the validity of competency assessment tools for 2 applications of critical care ultrasound and data on live versus video raters.

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Introduction and clinical scenarios

Point of Care Ultrasound for Emergency Medicine and Resuscitation ◽

10.1093/med/9780198777540.003.0001 ◽

2019 ◽

pp. 1-32

Author(s):

Paul Atkinson ◽

Bob Jarman ◽

Tim Harris ◽

Rip Gangahar ◽

David Lewis ◽

...

Keyword(s):

Emergency Medicine ◽

Critical Care ◽

Clinical Skills ◽

Point Of Care ◽

Clinical Care ◽

Critical Care Medicine ◽

Everyday Practice ◽

Point Of Care Ultrasound ◽

Clinical Scenarios ◽

Clinical Questions

Point-of-Care Ultrasound in Emergency Medicine and Resuscitation provides a curriculum-based guide to the integration of ultrasound into everyday practice for clinicians in emergency medicine and critical care medicine and for resuscitation. In addition to describing commonly used protocols, we focus on how ultrasound can be used to help to answer specific clinical questions and provide guidance for procedures at the point of care, augmenting traditional clinical skills. This chapter introduces the general concepts of using ultrasound at the bedside, describes how to use point-of-care ultrasound (PoCUS), and provides clinical scenarios as examples of where PoCUS can improve clinical care.

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