Cardiac POCUS in Pediatric Emergency Medicine: A Narrative Review

Area of Science:

• Emergency Medicine
• Pediatric Cardiology
• Point-of-Care Ultrasound

Background:

• Cardiac point-of-care ultrasound (POCUS) is a crucial diagnostic tool in the pediatric emergency department (PED).
• Its application extends to evaluating critically ill children, aiding in the detection of emergent cardiac pathology.

Purpose of the Study:

• To review the literature on cardiac POCUS in the PED.
• To assess its relevance to adult emergency medicine and other pediatric cardiac studies.
• To evaluate its role in detecting potentially emergent pediatric cardiac conditions.

Main Methods:

• Literature review of English-language studies.
• Inclusion of adult emergency literature relevant to pediatric applications.
• Consideration of pediatric cardiac studies outside the emergency setting.

Main Results:

• Pediatric emergency physicians can reliably detect reduced left-sided systolic function and pericardial effusion via POCUS.
• POCUS has been used to identify right-sided outflow tract obstruction, aortic root dilatation, and congenital heart disease.
• Training for cardiac POCUS competency is feasible and does not increase the burden on cardiology resources.

Conclusions:

• Pediatric cardiac POCUS offers a broad curriculum beyond basic assessments like systolic function and pericardial fluid.
• Further research is needed to evaluate physician performance in identifying a wider spectrum of cardiac pathology using POCUS.