Does POCUS Expedite Care?

This is the second study from the REASON group - one of the most rigorously performed studies of ultrasound in cardiac arrest. In this article, they are looking at the population in pulseless electrical activity (PEA) with cardiac motion on ultrasound. From this group, they differentiate those with organized rhythms. The idea is that perhaps this population would have a different survival or respond to treatments differently. By reanalyzing their previous data, they are able to answer these questions.

We have talked about ocular ultrasound many times before - it certainly can be useful in identifying many acute ophthalmologic pathologies. But what about papilledema?

Will it ever be good enough?

We know that ultrasound can be used to diagnose a superficial cutaneous abscess. That is NOT what this study is about. Forget diagnosing! What about actually helping your patients stay out of the emergency department?

It's not what you think - POCUS is not going to be used to diagnose a GI bleed. However, perhaps it can be used to risk stratify this diverse group of patients. These authors had the idea to check IVC, echo, and LVOT VTI to see if it could help predict which patients are going to have adverse events from their bleed.

Deep learning is a branch of artificial intelligence that holds a lot of promise for point-of-care ultrasound, but we don't have much data on how it performs. The fearless investigators in this fascinating study train a deep learning algorithm to recognize sonographic anatomy of the upper extremity and then pit it against expert POCUS users to see who can interpret the images most accurately!

The RUSH exam is a family favorite. It's a reliably easy to recall hypotensive protocol that uses ultrasound to help determine the etiology of a patient's shock. Well here's a new idea - trauma patient's can be in shock too, right? So maybe we should perform a full RUSH exam instead of just a measly EFAST? Well...hold your horses there kiddo, there may be more to think about with this one.