Ultrasound (US) carried out and interpreted by clinicians at the bedside is now called point-of-care US (POCUS). Clinical studies on POCUS have been carried out based on the ideas of "creation", "extraction", and "combination". "Creation" refers to findings for the upper airway and lung being obtained at the bedside. "Extraction" refers to findings suitable for POCUS being extracted from comprehensive US, including echocardiography, abdominal US, and whole-leg US. "Combination" refers to these POCUS applications being combined for the comprehensive assessment of patients with trauma, shock, or dyspnea. Emergency and critical care physicians have many opportunities to encounter trauma or non-trauma patients with shock, dyspnea, or both. Furthermore, the scope of POCUS includes many diseases and injuries that present with both shock and dyspnea. Therefore, we propose a basic POCUS framework based on the systematic airway, breathing, and circulation approach for the initial management of shock and dyspnea in adult patients. In this article, we update and review each application of POCUS and their combination in this framework. Furthermore, we propose the practical usage of the framework based on clinical presentations to improve the management of shock and dyspnea.
Keywords: Dyspnea; emergency department; point of care; shock; ultrasonography.
© 2020 The Authors. Acute Medicine & Surgery published by John Wiley & Sons Australia, Ltd on behalf of Japanese Association for Acute Medicine.