Hocus PoCUS: introducing point-of-care ultrasound

Abstract

Ultrasound technology is not new: case reports of its use in trauma were published many years ago. However, the technology and quality have been improving, becoming more compact and portable as well as, more importantly, reducing in cost. However, concerns from traditional specialties, with regard to quality and governance of practice, did ensure that the use of ultrasound by non-radiologists and nonsonographers was initially highly regulated and only accessible to users after significant training and practice. This created a situation where only a few progressed to accredited status, leaving the rest to either abandon hope or ‘tinker’. Fortunately, with time and multidisciplinary collaboration, such constraints were lifted and more realistic training and practice solutions were established. One example of how ultrasound has been embraced by non-traditional specialties is with the College of Emergency Medicine. Point-of-care ultrasound (PoCUS) will be a mandatory part of the curriculum for higher specialty training in emergency medicine from 2013. These core skills encompass four scanning modalities: focused assessment with sonography in trauma (FAST); detection of abdominal aortic aneurysms; focused echocardiography in cardiac arrest (ELS); and ultrasound guidance for insertion of central venous lines. What is important for all users of PoCUS to appreciate are the following golden rules: