All Journals from Nicholas Smallwood
Point of care ultrasound scanning (POCUS) is safe and effective in positively identifying lower limb DVT in emergency departments globally. In the UK, the requisite knowledge and skills are integrated into the FAMUS and FUSIC curricula.
Five FAMUS practitioners of varying experience performed 3-point compression POCUS on medical ambulatory and inpatients. Accuracy and timing of POCUS was compared between practitioners and with subsequent departmental scans.
89% sensitivity and 97% specificity were observed, with little difference between supervisors and candidates. Additionally, a significantly higher proportion of POCUS vs departmental scans (69% vs 7%, p = 0.0001) occurred within 24 hours of request.
Minimal experience was required to produce accurate results within ambulatory and internal medicine settings, and significant time savings can be made.
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Wheeze and shortness of breath are a common reason for admission to hospital but the cause of which is not always immediately apparent. We present a case of a patient with respiratory distress, wheeze and chest tightness on a background of well controlled asthma and androgen deprivation therapy for prostate cancer. The patient was provisionally treated as an asthma exacerbation but point of care ultrasound (POCUS) performed soon after admission revealed severe LV impairment and ‘wet lungs’ in keeping with acute decompensated heart failure. The case highlights the importance of POCUS to differentiate between different causes of wheeze in the acute setting and we discuss the diagnostic approach to the patient with suspected heart failure.
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