[Application of "Point-Of-Care-Ultrasound" (POCUS) in a Geriatric Home Care (AGD): A case report]

Executive summary of the consensus document on point-of-care ultrasound implementation: recommendations from the Clinical Ultrasound Working Groups of SEMI, SEDAR, SEGG, SEMERGEN, SEMES, SEMFYC, and SEMG

Point-of-Care Ultrasound has significantly evolved, establishing itself as an essential tool in daily medical practice, especially in various clinical contexts. This consensus document, supported by several Spanish medical societies, proposes guidelines for the effective integration of ultrasound in healthcare, promoting its standardization and ensuring the quality and systematic application of this technique. The working groups, composed of experts from different specialties, conducted a comprehensive review of the literature in MEDLINE and extensively discussed recommendations to formulate a coherent and practical set of guidelines for different application areas: hospital and out-of-hospital emergencies and critical care, primary care, and outpatient hospital care, hospitalization. The methodology included virtual meetings and confidential voting to reach a consensus on the relevant recommendations. Ultrasound was highlighted as fundamental in the initial approach to various pathologies, such as abdominal, thoracic, and musculoskeletal issues, facilitating quick and accurate diagnoses, and reducing the need for unnecessary referrals. Furthermore, this technique has proven valuable in emergencies and critical care, guiding procedures and enhancing the safety and efficiency of clinical interventions. These guidelines not only serve as a framework for clinical practice, education, and research but also aim to ensure that professionals are adequately trained and that ultrasound evaluations are performed to a standard of excellence. The purpose of these recommendations is to standardize and facilitate the adoption of this clinical tool in the daily practice of healthcare, thus improving the quality of the services provided in its various possible applications.

Usefulness of point of care ultrasound in older adults: a multicentre study across different geriatric care settings in Spain and the United Kingdom

BACKGROUND

Point of care ultrasound (POCUS) is an imaging technique performed bedside. To date, few published studies have reported the usefulness of multiorgan POCUS in Geriatrics. The objective of this study was to describe the utility of multiorgan POCUS in the care of older adults admitted to geriatric care settings.

METHODOLOGY

Observational retrospective study of patients admitted to geriatric settings in Spain and UK. Multiorgan POCUS was performed when there was a specific clinical suspicion or unexplained torpid clinical course despite physical examination and complementary tests. A geriatrician with a certificate degree in comprehensive ultrasound and long-standing experience in POCUS carried out POCUS. All patients underwent multiorgan POCUS in a cephalo-caudal manner.

RESULTS

Out of 368 patients admitted to geriatric units, 29% met the inclusion criteria. Average age was 85.9 years (SD ± 6.1). POCUS identified 235 clinically significant findings (2.2 per patient). Findings were classified as 37.9% confirmed diagnosis, 16.6% ruled out diagnosis, 14.9% unsuspected relevant diagnoses and 30.6% clinical follow-ups. POCUS findings led to changes in pharmacological and non-pharmacological treatment in 66.3 and 69.2% respectively, resulted in completion or avoidance of invasive procedures in 17.8 and 15.9%, respectively, facilitating early referrals to other specialities in 14.9% and avoiding transfers in 25.2% of patients.

CONCLUSION

Multiorgan POCUS is a tool that aids in the assessment and treatment of patients receiving care in geriatrics units. These results show the usefulness of POCUS in the management of older adults and suggest its inclusion in any curriculum of Geriatric Medicine speciality training.