Point-of-Care Ultrasound (POCUS) in Shock Diagnosis: Perceptions, Usage, and Barriers Among Emergency Physicians in...

Background Point-of-care ultrasound (POCUS) has become an important bedside tool for the rapid assessment of patients presenting with shock. However, data on its utilization and barriers among emergency physicians in Saudi Arabia remain limited. This study aimed to evaluate the frequency of POCUS use, physicians' perceptions, and barriers to its implementation in shock diagnosis among emergency physicians in Riyadh. Methods A cross-sectional survey was conducted among emergency medicine consultants, specialists, and senior residents practicing in Riyadh, Saudi Arabia. Participants were recruited between October 2025 and March 2026 using convenience and snowball sampling. The questionnaire assessed demographics, POCUS utilization, perceptions, benefits, barriers, and associated factors. Descriptive and inferential statistical analyses were performed using Stata version 18 (StataCorp, College Station, TX). Results A total of 152 emergency physicians were included in the analysis. Frequent POCUS use (daily or 3-5 times/week) was reported by 96 (63.2%) participants. The Rapid Ultrasound in SHock (RUSH) protocol was the most commonly used shock assessment protocol, reported by 137 (90.1%) participants. Most participants agreed that POCUS improves diagnostic accuracy (138 (90.8%)), reduces clinical decision-making time (132 (86.8%)), and should be a mandatory skill in emergency medicine training (142 (93.4%)). Faster diagnosis was identified as the most important benefit by 141 (92.8%) participants. The most commonly reported barriers were time constraints (93 (61.2%)), limited access to ultrasound machines (82 (54.0%)), and lack of formal training (78 (51.3%)). Frequent POCUS use was significantly associated with hospital type (χ² = 22.279, p < 0.001) and employment in a tertiary care center (χ² = 4.701, p = 0.030). Higher perception scores were associated with frequent POCUS use (z = 4.460, p < 0.001) and years of emergency medicine experience (χ² = 6.948, p = 0.031). Conclusion POCUS is widely utilized and highly valued by emergency physicians in Riyadh for the assessment of shock. Despite favorable perceptions, barriers related to training, equipment availability, and time constraints remain common. Structured training and institutional support may facilitate broader POCUS integration into emergency practice.