Decreasing morbidity and improving workflow with point‐of‐care ultrasound in the Emergency Department

Abstract

Point‐of‐Care Ultrasound (POC US) has been increasingly performed in emergency medicine for a variety of indications. However, pediatric emergency physicians have been slower to understand the importance of POC US in the diagnosis of critical care cases.Here I report a case of a two year‐old male that presented to the emergency department (ED) with vomiting and abdominal pain. On arrival to the ED, an immediate diagnosis of intussusception was made using real‐time POC US by a pediatric emergency attending well trained in pediatric US. This illustrates the impact that POC US can make with an early diagnosis of intussusception. This diagnosis is best made by an experienced sonographer, such as the radiologist. However, in some pediatric hospitals, radiology department US may not be readily available. The intussusception mass is a large structure and characteristically does not contain any bowel gas, which makes it readily identifiable with US. Studies have shown that extensive training and experience is not necessary for high accuracy in diagnosing intussusception.With thorough knowledge of the US features characteristic of intussusception, its accurate diagnosis using POC US has the potential to reduce morbidity and mortality as well as improve patient flow, work flow and throughput time in the ED. Training of pediatric emergency physicians in POC US is highly advised.