Abstract

Point of care ultrasound (POCUS) as a diagnostic tool can provide key real-time physiological and anatomical information for the emergency physician in a paediatric resuscitation, facilitating rapid diagnostic streaming at key junctions of clinicotherapeutic algorithms. In undifferentiated severe respiratory distress, POCUS can identify pneumothorax, pleural effusions and pulmonary oedema, with sensitivities greater than or equal to chest X-ray. Contributing or causative factors for poor output can be identified by POCUS in up to 80% of cases of shock or of electrocardiographic pulseless electrical activity (PEA), which can be further subdivided into PEA with or without effective contractility. Use of POCUS in cardiac arrest requires an experienced scanner separate from the cardiopulmonary resuscitation (CPR) director, and must be limited to the 10 second pulse check. Despite the significant educational investment required for this, it is a challenge which paediatric emergency medicine physicians and leaders must meet to improve outcomes and better understand pathophysiology in the severely ill infants and children we treat.

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