SHM Converge Scientific Abstract ePoster Gallery-Use Cases for Point-of-Care Ultrasound Within Hospital Medicine: A Scoping Review

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This scoping review examined how point-of-care ultrasound (POCUS) may be used in hospital medicine and where the evidence remains limited. The authors reviewed PubMed Central reports for four inpatient use cases: pneumonia, jugular venous distension/right atrial pressure estimation, deep vein thrombosis (DVT), and ultrasound-guided intravenous catheter placement.<br /><br />Overall, the literature suggests that some POCUS applications perform well, especially pneumonia and DVT. For pneumonia, 24 prospective studies involving 2,923 patients showed generally strong diagnostic performance, although none were conducted in the United States. For DVT, 21 prospective studies with 4,080 patients found high sensitivity and specificity, and the three-point compression technique may be especially useful for acutely ill inpatients because isolated femoral DVTs appear relatively common. DVT ultrasound may also save substantial time compared with waiting for radiology sonographers, especially in settings without 24/7 availability.<br /><br />Evidence for ultrasound assessment of jugular venous distension is more mixed. Fourteen prospective studies (1,477 patients) showed a correlation between ultrasound-estimated jugular venous elevation and right atrial pressure, but methods varied widely, including differences in what was measured and the head-of-bed angle used.<br /><br />For ultrasound-guided IV placement, 16 prospective studies (2,153 patients) showed improved initial success rates in patients with difficult venous access. However, the studies mostly used a single-operator dynamic technique, and ultrasound may add time or reduce efficiency in patients with easy access.<br /><br />The review concludes that while several POCUS applications are promising in hospital medicine, much of the evidence comes from non-inpatient or non-U.S. settings. More prospective research in general inpatient populations is needed.

Asset Subtitle

David F. Lee

Meta Tag

Author List David F. Lee, James C. Hudspeth, Lao-Tzu Allan-Blitz, Michael Schwartz

Category Research

Concept Point-of-Care Ultrasound

Concept Deep Vein Thrombosis

Concept Hospital Medicine

Concept Pneumonia

Concept Jugular Venous Distension

Distinguished Non-Finalist

Presenter Organization Brigham and Women's Hospital

Presenting Author David F. Lee

Track Technology in Hospital Medicine

Keywords

point-of-care ultrasound

hospital medicine

pneumonia

deep vein thrombosis

jugular venous distension

right atrial pressure

ultrasound-guided intravenous catheter placement

inpatient diagnostics

prospective studies

diagnostic performance

Point-of-Care Ultrasound

Deep Vein Thrombosis

Hospital Medicine

Pneumonia

Jugular Venous Distension