Point-of Care Heart and Lung Ultrasound Clinical Practice Guidelines (EFSUMB, 2022)

European Federation for Ultrasound in Medicine and Biology

These are some of the highlights of the guidelines without analysis or commentary. For more information, go directly to the guidelines by clicking the link in the reference.

November 02, 2022

Guidelines on heart and lung point-of-care ultrasound (PoCUS) were published in October 2022 by the European Federation for Ultrasound in Medicine and Biology (EFSUMB) in the European Journal of Ultrasound.[1]

The guidelines include recommendations for PoCUS in patients with pericardial effusion and cardiac tamponade, aortic root dissection, cardiac arrest, pulmonary embolism, deep vein thrombosis, pneumothorax, pulmonary effusion, lung consolidations, and interstitial fluid syndrome.

Add PoCUS to the physical examination in patients with hypotension and/or cardio-respiratory symptoms to improve early identification of pericardial effusion/tamponade.

PoCUS may help predict survival when used to determine whether cardiac activity is present in adults with cardiac arrest. The absence of cardiac activity is associated with a very low possibility of survival in patients with traumatic cardiac arrest (TCA) and may be helpful when deciding to stop resuscitation; however, patients with medical cardiac arrest (MCA) have a low but not no possibility of return of spontaneous circulation (ROSC)/survival, and the decision to stop resuscitation should not be based on PoCUS alone.

PoCUS by non-specialists may assist in the diagnosis of hemodynamically unstable pulmonary embolism (PE).

PoCUS may be used to diagnose deep venous thrombosis (DVT) in the ED. Less experienced emergency physicians may be able to conduct a shortened PoCUS exam for DVT with good but not perfect accuracy, particularly after focused training. 

PoCUS has good diagnostic accuracy for identifying pneumothorax.

PoCUS has superior diagnostic accuracy for pleural effusions when compared with chest x-ray and clinical examination.

PoCUS may be used to diagnose pneumonia.

PoCUS may be used in the ED to diagnose interstitial fluid syndromes in adults.

For more information, please see: Bedside Ultrasonography for Pneumothorax, Pericardial Effusion Imaging, and Imaging in Deep Venous Thrombosis of the Lower Extremity.

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