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Updated: Oct 6, 2025
A Modified Sonographic Algorithm for Image Acquisition in Life-Threatening Emergencies in the Critically Ill Newborn
Published on: April 7, 2023
Point-of-care ultrasound for children
Ko Ichihashi1, Kazuhito Nonaka2
1Department of Pediatrics, Jichi Medical University Saitama Medical Center, 1-847 Amanuma, Omiya, Saitama-shi, Saitama, 330-8503, Japan. koichihashi@jichi.ac.jp.
Insights
Point-of-care ultrasound (POCUS) offers a radiation-free imaging alternative for pediatric emergencies. Specialized techniques and training are crucial for effective pediatric POCUS implementation and patient safety.
Area of Science:
- Pediatric Emergency Medicine
- Medical Imaging
- Ultrasound Technology
Background:
- Pediatric diseases are often acute, necessitating rapid diagnostic imaging.
- Children's sensitivity to radiation makes alternatives to X-ray and computed tomography (CT) desirable.
- Point-of-care ultrasound (POCUS) presents a valuable, radiation-free imaging modality for pediatric patients.
Purpose of the Study:
- To highlight the utility and specific considerations of pediatric POCUS.
- To address the unique challenges and requirements for performing ultrasound in children.
- To advocate for increased adoption and education in pediatric POCUS.
Main Methods:
- Review of pediatric ultrasound applications and anatomical considerations (e.g., open fontanelles).
- Discussion of technical adjustments for pediatric imaging (e.g., higher frequency probes, frame rates).
- Exploration of POCUS's role in pediatric procedural guidance and safety.
Main Results:
- Pediatric POCUS targets the same organs as adult ultrasound, with unique access to infant brains via fontanelles.
- Specific pediatric considerations include non-compliant infants and the need for specialized equipment settings.
- POCUS enhances diagnostic accuracy and procedural safety in pediatric care.
Conclusions:
- Pediatric POCUS is a powerful tool for diagnosis and procedural safety, despite limited current adoption.
- Addressing challenges like infant immobility and technical requirements is key.
- Development of targeted educational programs is essential to expand pediatric POCUS utilization.
Abstract:
Most diseases in children are acute, and ultrasonography should be performed in emergency cases rather than X-ray or computed tomography (CT) as children are more sensitive to radiation than adults. Therefore, point-of-care ultrasound (POCUS) is especially useful in children. The target organs of pediatric ultrasound are the same as in adults, and the infant brain can also be observed with ultrasound because the fontanel magna is still open. However, there are a number of points that physicians should be aware of regarding pediatric POCUS. There are some diseases specific to children, which are not found in adults. A higher frequency probe and higher frame rate are needed for children than for adults because of their small body size and rapid heart rate. Infants are not compliant, which necessitates the use of various measures to ensure that they remain still during the imaging examination. Pediatric POCUS is useful not only for diagnosis but also to ensure the safety of medical procedures, which is usually more difficult in children than in adults. POCUS has become a powerful tool for improving the success of such procedures and patient safety. The usefulness of POCUS is clearly evident, and it is being widely adopted across all disciplines in clinical medicine. Nevertheless, adoption of pediatric POCUS has been limited, and therefore educational programs for pediatric POCUS are needed.
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