POCUS journal最新文献

{"title":"Peritoneal Volume Influence on POCUS Volume Assessment in Patients Undergoing Peritoneal Dialysis.","authors":"María Muñiz Rincón, Diego Barbieri, Virginia López de la Manzanara, Elena Ruiz Ferreras, Arianne Aiffil Meneses, Carlos Fernández Fernández, Cristina Riaza Ortiz, Rómulo Loayza López, Jose Antonio Herrero Calvo, Ana I Sanchez-Fructuoso","doi":"10.24908/pocusj.v10i02.19345","DOIUrl":"10.24908/pocusj.v10i02.19345","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to investigate variations in fluid overload using point of care ultrasound (POCUS). We assessed patients undergoing peritoneal dialysis (PD) with full and drained peritoneum and their correlation with clinical parameters.</p><p><strong>Methods: </strong>POCUS examination and intra-abdominal pressure (IAP) measurements were conducted in patients undergoing PD with a full peritoneum. Subsequently, after drainage, a new POCUS and bioimpedance analysis (BIA) were performed.</p><p><strong>Results: </strong>Seventeen patients were included in the study: 70.6% male, mean age 66+/-9.5 years. Of these, 65% had fluid overload >1 L and 23% had overhydration (OH) adjusted for extracellular water (ECW) exceeding 15%, as assessed by BIA. B-lines with full peritoneum had a median of 1 (0-2.5), and with drained peritoneum 0 (0-0). This difference was not statistically significant (p=0.063). In the correlation analysis of variables, IAP and PD fluid volume per m2 of body surface did not correlate with the diameters or collapsibility of the inferior vena cava (IVC) with full or drained peritoneum. The degree of OH in liters correlated with IVC collapsibility with drained peritoneum (Spearman ρ=-0.43; p=0.08), as did the OH adjusted for ECW (Spearman ρ=-0.61; p=0.02). These correlations disappeared with full peritoneum (p>0.05).</p><p><strong>Conclusions: </strong>There were no significant differences in ultrasound volume overload parameters in patients undergoing PD with full vs. drained peritoneum. However, there are indications of lower POCUS sensitivity to fluid overload with a full peritoneum.</p>","PeriodicalId":74470,"journal":{"name":"POCUS journal","volume":"10 2","pages":"79-85"},"PeriodicalIF":0.0,"publicationDate":"2025-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12658580/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145650369","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Respecting Learner Autonomy in POCUS Image Acquisition - a Stepped Approach.","authors":"David Purkarthofer, Simon Orlob","doi":"10.24908/pocusj.v10i02.19791","DOIUrl":"10.24908/pocusj.v10i02.19791","url":null,"abstract":"","PeriodicalId":74470,"journal":{"name":"POCUS journal","volume":"10 2","pages":"11-12"},"PeriodicalIF":0.0,"publicationDate":"2025-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12658568/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145650338","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Utilizing POCUS for the Identification and Management of PICC Line-Associated Cardiac Tamponade.","authors":"Pedro Jose Cruz Guzman, Karen Lidsky, William Hanna","doi":"10.24908/pocusj.v10i02.18439","DOIUrl":"10.24908/pocusj.v10i02.18439","url":null,"abstract":"<p><p>Peripherally inserted central catheters (PICCs) are commonly used in pediatric patients, but rare complications such as cardiac tamponade can occur. This case report describes a 5-month-old ex-premature infant who developed cardiac tamponade associated with PICC line malposition. Point of care ultrasound (POCUS) was used to diagnose and effectively manage the condition peri-arrest via emergent pericardiocentesis. The report highlights the role of POCUS in the prompt identification and treatment of hemodynamic deteriorations and posits potential utilization of POCUS as a tool in preventative surveillance.</p>","PeriodicalId":74470,"journal":{"name":"POCUS journal","volume":"10 2","pages":"21-23"},"PeriodicalIF":0.0,"publicationDate":"2025-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12658562/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145650362","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Giant Pyonephrosis Diagnosed Using POCUS in a Resource-Limited Setting.","authors":"Roody Menager, Rebecca St Louis, Anst Gelin, Flawendjee Djaweelentz Jacques","doi":"10.24908/pocusj.v10i02.19112","DOIUrl":"10.24908/pocusj.v10i02.19112","url":null,"abstract":"<p><p>Pyonephrosis is a severe complication of hydronephrosis and can lead to the destruction of the renal parenchyma, sepsis, shock, and death. The clinical presentation is nonspecific, and 15% of patients are asymptomatic on presentation. In resource-limited settings, where Computed Tomography (CT) imaging is not available, point of care ultrasound (POCUS) plays an important role in evaluating kidney diseases in the emergency department (ED). In this case, a 36-year-old man presented to the ED with dyspnea, fever, abdominal pain, and abdominal distention in the area where an intra-abdominal tumor was reported. After ultrasound-guided aspiration, pyonephrosis was diagnosed. In the absence of other capable specialists, the emergency physician performed a percutaneous nephrostomy procedure, and eight liters of pus were removed. The patient improved significantly and was discharged from the ED with oral antibiotics and scheduled urology follow-up in the clinic.</p>","PeriodicalId":74470,"journal":{"name":"POCUS journal","volume":"10 2","pages":"75-78"},"PeriodicalIF":0.0,"publicationDate":"2025-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12658564/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145650223","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"POCUS for Detection of Esophageal and Gastric Foreign Bodies.","authors":"Daniella Lamour, Jacqueline Jean-Gilles, David Kinas, Edward Lopez, Robert A Farrow","doi":"10.24908/pocusj.v10i02.19230","DOIUrl":"10.24908/pocusj.v10i02.19230","url":null,"abstract":"<p><strong>Background: </strong>Foreign body ingestion is a common and challenging complaint for physicians in the emergency department (ED). Although most foreign bodies pass naturally without surgical intervention, about 10-20% require removal based on their size, shape, and location within the gastrointestinal tract. X-rays and computed tomography (CT) scans are frequently used for evaluation. However, x-rays cannot detect radiolucent foreign bodies, both modalities emit ionizing radiation, and CT scans are notably expensive. Point of care ultrasound (POCUS) offers a valuable alternative for detecting foreign bodies, as it avoids radiation exposure, reduces costs, and is readily accessible.</p><p><strong>Case series: </strong>We present a case series involving three distinct instances of foreign body ingestion, where POCUS enhanced patient outcomes and disposition. This series includes evidence on use of POCUS for an obstructed esophageal foreign body and two gastric foreign bodies in a stable patient and unstable altered patient suspected of medication overdose.</p><p><strong>Conclusion: </strong>POCUS is an effective tool for identifying foreign bodies in the upper gastrointestinal tract, especially when x-rays fail to visualize non-radiopaque materials or when attempting to minimize radiation from CT scans. It allows emergency physicians to quickly confirm the presence and precise location of foreign bodies in the gastrointestinal tract, leading to faster clinical decision making and reduced risk of complications, such as perforation or obstruction.</p>","PeriodicalId":74470,"journal":{"name":"POCUS journal","volume":"10 2","pages":"71-74"},"PeriodicalIF":0.0,"publicationDate":"2025-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12658578/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145650354","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Retrospective Proof-of-Concept Study of the Impact of Point of Care Ultrasound During Short-Term Surgical Missions.","authors":"Harsh Sule, Rolando Valenzuela, Vennila Padmanaban, Enoch Obeng, Georgia Davies, Francisco Alvarado, Ziad Sifri","doi":"10.24908/pocusj.v10i02.18453","DOIUrl":"10.24908/pocusj.v10i02.18453","url":null,"abstract":"<p><p>Point of care ultrasound (POCUS)-use during short-term surgical missions (STSMs) to resource-limited settings has not been well studied. We conducted a retrospective analysis of POCUS use during the perioperative course of patients undergoing definitive surgical treatment over the course of two STSMs. A total of 58 perioperative POCUS exams were performed by emergency physicians on our team. Operative findings correlated with POCUS results in 90% of cases that underwent surgery, while surgery was deferred based on POCUS findings in 33% of scans. Our findings suggest that POCUS is a portable, rapid and cost-effective modality that can be used in a focused manner in the perioperative period. Specifically, our inter-disciplinary experience and results demonstrate that POCUS-use has a positive impact on patient safety and quality, and optimizes the use of valuable resources and time.</p>","PeriodicalId":74470,"journal":{"name":"POCUS journal","volume":"10 2","pages":"91-96"},"PeriodicalIF":0.0,"publicationDate":"2025-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12658573/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145650057","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"POCUS-Guided Forearm Nerve Blocks for Analgesia of Acute Hand Ischemia in the Emergency Department.","authors":"Richard J Gawel, Sydney Sillart, Nova Panebianco, Michael Shalaby, Ian P Ciesielski","doi":"10.24908/pocusj.v10i02.19734","DOIUrl":"10.24908/pocusj.v10i02.19734","url":null,"abstract":"<p><strong>Background: </strong>Acute limb ischemia (ALI) is a vascular emergency associated with significant pain that can be challenging to manage, especially in opioid-tolerant patients.</p><p><strong>Case report: </strong>A 44-year-old man with opioid use disorder presented with ALI of the right hand not amenable to surgical intervention after self-injection of fentanyl. Despite high-dose opioids, he continued to experience refractory pain. Point of care ultrasound (POCUS)-guided radial and median nerve blocks performed in the emergency department provided substantial relief.</p><p><strong>Discussion: </strong>This case illustrates the novel use of POCUS-guided upper extremity regional anesthesia by emergency physicians to manage ALI pain. POCUS-guided regional anesthesia may be a safe, effective adjunct in select patients, though patients must be closely monitored for complications.</p>","PeriodicalId":74470,"journal":{"name":"POCUS journal","volume":"10 2","pages":"53-56"},"PeriodicalIF":0.0,"publicationDate":"2025-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12658572/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145650402","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"POCUS: Presence, Observation, Connection, Understanding, Story.","authors":"Sanjay A Patel","doi":"10.24908/pocusj.v10i02.19432","DOIUrl":"https://doi.org/10.24908/pocusj.v10i02.19432","url":null,"abstract":"","PeriodicalId":74470,"journal":{"name":"POCUS journal","volume":"10 2","pages":"20"},"PeriodicalIF":0.0,"publicationDate":"2025-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12658561/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145650344","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"When Omental Infarction Imitates Appendicitis: Advancing Diagnosis with POCUS.","authors":"David J McCreary, Iain Fraser, Nigel Chan","doi":"10.24908/pocusj.v10i02.19337","DOIUrl":"10.24908/pocusj.v10i02.19337","url":null,"abstract":"<p><p>A previously healthy 12-year-old boy presented to the paediatric emergency department on three occasions in the space of four days with progressive right iliac fossa pain. His presentation appeared consistent with appendicitis; however, blood tests remained normal at each presentation. Point of care ultrasound (POCUS) revealed significant inflammatory changes in the right lower quadrant along with free fluid. Due to worsening pain and advancing findings on POCUS, the patient underwent a diagnostic laparoscopy which identified a normal appendix but had features consistent with omental infarction. Omental infarction is a rare condition that can mimic appendicitis, with few recorded cases in the literature. This is the first documented case of POCUS being utilised in the evaluation of a child with omental infarction. While the patient's diagnosis was less common than initially suspected, POCUS played a crucial role in guiding timely and effective patient care, highlighting its value in clinical decision-making However, there are indications of lower POCUS sensitivity to fluid overload with a full peritoneum.</p>","PeriodicalId":74470,"journal":{"name":"POCUS journal","volume":"10 2","pages":"97-102"},"PeriodicalIF":0.0,"publicationDate":"2025-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12658570/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145650349","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Building a Point of Care Ultrasound (POCUS) Curriculum in Undergraduate Medical Education Through Stepwise Development and Assessment.","authors":"Nancy L Hagood, Romik Srivastava, Marc E Heincelman, Meghan K Thomas","doi":"10.24908/pocusj.v10i01.18116","DOIUrl":"https://doi.org/10.24908/pocusj.v10i01.18116","url":null,"abstract":"<p><strong>Background: </strong>Point of care ultrasound (POCUS) training is increasingly incorporated in undergraduate medical education (UME). However, limited resources and lack of standard guidelines lead to questions regarding the most effective curriculum and assessment method. The authors aimed to develop a longitudinal UME POCUS curriculum through staged intervention. Year 1, which involved simulation alone, led to improved confidence without adequate knowledge. The authors hypothesized that the addition of resident-led workshops alongside faculty-led lectures would improve POCUS knowledge and confidence among third-year medical students.</p><p><strong>Methods: </strong>A prospective cohort study of third-year students on the Internal Medicine (IM) clerkship at a large academic medical center was performed, assessing efficacy of stepwise POCUS curriculum development. Previously implemented year 1 involved comparing the control cohort receiving baseline POCUS education on rounds with the experimental cohort that had access to a high-fidelity POCUS simulator. The year 2 cohort added hands-on resident-led POCUS workshops. The year 3 cohort added faculty-led lectures. All cohorts completed pre- and post-intervention confidence and knowledge-based examinations. The year 1 control cohort served as a control for the current study.</p><p><strong>Results: </strong>A total of 69 and 102 students completed both pre-/post-tests among year 2 and 3 cohorts, respectively. Both cohorts demonstrated statistically significant improvement in POCUS knowledge and confidence, with greater magnitude of improvement in year 3 with overall knowledge improving from 49.9% to 66.7% on pre- to post-intervention examination (p<0.0001).</p><p><strong>Conclusion: </strong>While simulation alone was insufficient to instill knowledge, the addition of resident-led workshops and faculty-led lectures demonstrated benefits in POCUS knowledge and confidence among medical students and represents a sustainable model of training.</p>","PeriodicalId":74470,"journal":{"name":"POCUS journal","volume":"10 1","pages":"32-37"},"PeriodicalIF":0.0,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12057471/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144000070","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}