Point of care ultrasound and shock: The value in bedside diagnosis and hemodynamic assessment in undifferentiated shock patients

Abstract

Point of care ultrasound (POCUS) was introduced as a tool for critical care assessment in the 1990s and has since grown to be a tool for quantitative and qualitative data. Adopted initially by the emergency medicine community, it has recently been integrated into medical education for numerous specialties. It remains a valuable adjunct in the initial evaluation of patients as a widely available portable resource and provides real-time imaging. In patients who present in undifferentiated shock, visualization of the heart and lungs using POCUS can help delineate the cause of the clinical decompensation. Cardiac evaluation can look for right and left ventricular dysfunction, estimate left ventricle ejection fraction, evaluate for cardiac tamponade, and detect new wall motion abnormalities. Assessment of the lungs can add additional insight into underlying pathology. In patients who suffer cardiac arrest, POCUS can help identify any potentially reversible causes. It can also be used for hemodynamic assessment to aid in the resuscitation of patients with shock by evaluating of the inferior vena cava, hepatic, and renal veins. Here we provide a resource to describe not only the numerous benefits of POCUS in assessing and monitoring critically ill patients, but also the imaging findings of life-threatening diagnoses.