Management of shock using point-of-care ultrasound

Abstract

Point-of-care ultrasound (POCUS) is useful for initial management of shock. Focused assessment with sonography for trauma (FAST) is performed for the rapid detection of cardiac tamponade, hemothorax, and hemoperitoneum, which can cause shock. Many clinical studies have shown the effectiveness and feasibility of cardiac POCUS performed by clinicians who are not specialized in echocardiography, which is now called focused cardiac ultrasound (FOCUS). Rapid ultrasound in shock (RUSH) is a comprehensive assessment method based on the classification of shock. POCUS is also useful for the rapid assessment of dyspnea and the confirmation and guidance of procedures in acute care settings. A POCUS framework based on the airway, breathing, and circulation approach (ABC-POCUS) systematically lays out all POCUS applications that are useful for the initial management of shock and dyspnea. It is appropriate to select POCUS applications from the framework or to use the framework as a protocol based on the clinical reasoning.