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Expanding Horizons of Pediatric POCUS: Applications in the Older Child
Deeksha Bhalla1, Pooja Abbey1, Swati Dublish2
1Department of Radiodiagnosis, Lady Hardinge Medical College, New Delhi, India.
Insights
Point of care ultrasonography (POCUS) enhances pediatric emergency care by guiding rapid management. This review explores advanced POCUS applications in thoracic, abdominal, and vascular assessments, plus procedural guidance.
Area of Science:
- Pediatric Emergency Medicine
- Critical Care
- Diagnostic Imaging
Background:
- Point of care ultrasonography (POCUS) is vital in emergency rooms and ICUs for rapid pediatric patient management.
- Targeted examinations with checklists ensure speed and accuracy.
- Expanding POCUS scope beyond common uses is crucial.
Purpose of the Study:
- To review less explored applications of POCUS in pediatric critical care.
- To provide a comprehensive guide for POCUS utilization in various pediatric scenarios.
- To detail established criteria and indices for specific pathologies.
Main Methods:
- Literature review focusing on advanced POCUS applications.
- Categorization of applications into thoracic, abdominal, vascular, and procedural.
- Inclusion of defined ultrasound criteria and calculable indices.
Main Results:
- Detailed evaluation of thoracic applications: pleural collections and diaphragmatic motility.
- Comprehensive review of abdominal applications for acute abdomen in children.
- Assessment of vascular evaluation in pediatric shock and bedside procedures.
Conclusions:
- POCUS offers expanded utility in pediatric emergency and critical care settings.
- This review provides a framework for utilizing advanced POCUS techniques.
- Standardized criteria and indices enhance diagnostic accuracy and management.
Abstract:
Point of care ultrasonography (POCUS) is being increasingly employed in the emergency room as well as in intensive care units (ICUs) to guide rapid management of sick children while avoiding shifting them away from their primary treating physician. The examination must be targeted, with a checklist approach based on clinical signs, to enable both speed and accuracy. This review brings forth some less explored applications of POCUS, in order to expand its scope. The first section deals with thoracic applications, including detailed evaluation of pleural collections and diaphragmatic motility. The second section deals with abdominal applications, including the common causes of acute abdomen in children. The third section deals with evaluation of vessels in shock. Finally, the last section touches upon bedside ultrasonography guided procedures in children. Defined US criteria available in literature for abdominal pathology as well as established indices which can be calculated have been also detailed in this review.
