Focused and Point-of-Care Ultrasound

This page is designed to offer resources to those who use ultrasound as an adjunct to their work. This may include professionals such as GPs, emergency physicians, intensivists, physiotherapists, and podiatrists.

 

What is PoCUS?

PoCUS, or point-of-care ultrasound, covers a huge array of applications, which continue to expand rapidly but most often it refers to a focused ultrasound examination performed for a specific clinical question or for specific symptoms at the patient's bedside remote from the radiology department.

Commonly, PoCUS refers to an ultrasound examination performed by a non-imaging specialist, such as staff in the Emergency Department, the Intensive Care Unit, Urology, and, increasingly, in GP surgeries.  In addition, PoCUS frequently aids the decision-making of obstetricians, physiotherapists, podiatrists, paramedics and other practitioners in a variety of locations.  Clearly, the scope is vast.

 

Does BMUS support PoCUS?

BMUS supports all technologies and practices that expedite safe and effective patient care.  In appropriately trained hands, ultrasound is a relatively inexpensive but powerful diagnostic tool that often provides instant answers.  BMUS supports all PoCUS applications when it is being used in an attempt to answer a clinical question such as;

Is there free fluid in the abdomen? 

Is the fetus cephalic? 

Is there a pericardial effusion? 

Is there urinary retention?

Is there a Morton's neuroma?

 

Who should do PoCUS?

The background of the healthcare professional is irrelevant.  What is of importance is that the professional has a full understanding of their scope of practice and has successfully completed a recognised ultrasound course covering core topics:

  • Safety, physics, equipment and QA
  • Sonographic anatomy and pathology
  • Interpretation of images and recognition of artefacts
  • Documentation of findings
  • Audit and ongoing CPD

A joint paper on ultrasound governance for those practising outside the remit of radiology departments will be published by BMUS and the Royal College of Radiologists later this year.  In the meantime we direct PoCUS users to our statement from March last year:

BMUS Best practice statement on recording and storage of point-of-care ultrasound examinations

The following guidance has been produced by BMUS to assist users of ultrasound to adhere to best practice with regards to reporting and storage of images obtained from point-of-care ultrasound examinations.  Click here for recommendations and suggested reporting template.

 

How can I learn PoCUS?

There are many established short courses tailored to the requirements of specific PoCUS applications.  If there does not appear to be one below suited to your needs, we suggest you contact your professional organisation for advice in the first instance.  It is important that your course ends with a robust, practical competence assessment.

Intensive care - https://www.ics.ac.uk/Society/Learning/FUSIC_Accreditation

Acute medicine - https://www.acutemedicine.org.uk/FAMUS/

Emergency medicine - https://rcem.ac.uk/ultrasound/

Physiotherapy - https://www.csp.org.uk/professional-clinical/professional-guidance/point-care-ultrasound-physiotherapy-practice

In addition, the Consortium for the Accreditation of Sonographic Education (CASE) accredits a number of focused courses that are listed in their current directory - Directory of Courses 2021 - 2022 v3.pdf

University postgraduate PoCUS courses include:

https://www.derby.ac.uk/postgraduate/radiography-courses/medical-ultrasound-msc/

https://www.kcl.ac.uk/news/clinical-ultrasound-launching-september-2022 

https://www.tees.ac.uk/postgraduate_courses/nursing_&_health/msc_medical_ultrasound.cfm

 

Interesting cases

This first case may be of interest particularly to ultrasound practitioners in the ED setting.  Click here to view.

 

Useful Resources

British Society of Echocardiography

The British Society of Echocardiography offers comprehensive guidelines for cardiac examination.  See here for details or visit their website at www.bsecho.org

The Care Quality Commission

The Care Quality Commission is the independent regulator of health and social care in England.  Most services using ultrasoud will require registration with and inspection by the CQC.  Link to their home page here.

 

Contemporary PoCUS-related articles

EFSUMB Clinical practice guidelines for point-of-care ultrasound: Part 1. (Common heart and pulmonary applications) (2022)

An initial framework for use of utrasound by speech and language therapists in the UK (2022)

Use of home ultrasound (2022)

Is there a place for point-of-care ultrasound in UK primary care? - PMC (nih.gov) (2020)

Proposed framework for PoCUS lung ultrasound by physiotherapists (2022)

PoCUS in pelvic health (2022)

Point-of-care ultrasound: unnecessary gadgetry or evidence-based medicine? (2018)

BMUS members will also have open access to the full PoCUS series of articles that were co-ordinated by Professor Bob Jarman and published in the journal Ultrasound from February 2011 onwards.