Top evidence-based reasons why patients love POCUS.

Point-of-care ultrasound (POCUS) has rapidly become a valuable tool in the medical field, with applications ranging from emergency medicine to primary care. As providers, we love it because it eliminates the guessing game and allows us to be more efficient. Well, patients appreciate better and more efficient care too! Furthermore, they get to spend more time with their provider at the bedside, which is invaluable. Numerous studies show that POCUS has a significant positive impact on the patient experience, improving satisfaction, communication, and outcomes. Let us examine the data!

Improved diagnostic accuracy and avoidance of invasive procedures

Patients value correct diagnosis because it allows them to begin appropriate treatment sooner and avoids unnecessary diagnostic tests and procedures, specialist visits, and potential side effects of incorrect treatment. POCUS was found to change diagnosis or management in 71.8% of cases in a study of 528 patients presenting for primary care visits[1]. POCUS also changed management in 56% of patients who presented to the ED with concerns for an abscess[2]. Consider how happy a patient would be if POCUS enabled them to avoid the dreaded incision and drainage (I&D). In more emergent presentations, POCUS changed management in 33% of trauma patients[3] and 25% of patients with nontraumatic hypotension[4]. POCUS enables clinicians to provide better care and patients are on board with it.

Greater efficiency

POCUS not only leads to more accurate diagnoses, but it also expedites care by avoiding time-consuming tests (CT scan, comprehensive ultrasound in radiology department) as well as hospital admissions (e.g., pending gallbladder ultrasound once radiology department opens) and referrals (e.g., referral for urgent vascular study to rule out deep vein thrombosis). POCUS can provide answers in both cases within minutes. POCUS has also been shown to reduce time to diagnosis in patients with pulmonary complaints from 186 minutes to 24 minutes [5] and the length of stay in the ED by 65 minutes in patients with abdominal pain[6]. Regardless of how much they like their doctors, most patients prefer to leave the hospital and recover at home. Furthermore, uncertainty frequently leads to anxiety. Patients are more likely to focus their energy on the treatment process rather than worrying about what is wrong if they know what is wrong as soon as possible.

Decreased procedural complications

POCUS keeps patients safe by avoid bleeding complications from thora- and paracentesis, failed attempts at procedures, and pneumothoraces from central line insertion and thoracentesis (POCUS decreased pneumothorax rate from 12.5% to 1.25% [7]). In addition, by utilizing POCUS to insert peripheral IVs in patients with difficult veins, central lines and the associated complications (infection, pneumothorax, arterial puncture) are prevented. Avoiding complications (POCUS decreases internal jugular (IJ) central line placement complications by 71%[8]) or more invasive procedures means less pain and anxiety for the patient, as well as less time in the hospital and away from family and work.

Enhanced communication and trust

Finally, POCUS can help clinicians and patients communicate better. A 2021 study published in BMC Family Practice found that POCUS assisted 82% of patients in better understanding their health. 65% of patients also reported increased trust in primary care physician’s assessment when POCUS was used[9]. POCUS is a visual aid that helps to convey a medical condition more effectively. Better understanding of the problem and enhanced trust in their medical provider inevitably leads to greater patient treatment compliance and outcomes.

It is clear that POCUS has a major positive impact on the patient experience. By providing rapid and accurate diagnoses, increasing patient engagement, minimizing the need for invasive procedures, and improving communication, POCUS can help patients feel more confident in their care and ultimately lead to better outcomes. As POCUS becomes more widely available, we can expect to see even more benefits for patients and clinicians alike.

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References:

1.     Aakjær Andersen C, Brodersen J, Davidsen AS, Graumann O, Jensen MBB. Use and impact of point-of-care ultrasonography in general practice: a prospective observational study. BMJ Open. 2020 Sep 17;10(9):e037664. doi: 10.1136/bmjopen-2020-037664. PMID: 32948563; PMCID: PMC7500300.

2.    Tayal VS, Hasan N, Norton HJ, Tomaszewski CA. The effect of soft-tissue ultrasound on the management of cellulitis in the emergency department. Acad Emerg Med. 2006;13(4):384-388. doi:10.1197/j.aem.2005.11.074

3.     Ollerton JE, Sugrue M, Balogh Z, D'Amours SK, Giles A, Wyllie P. Prospective study to evaluate the influence of FAST on trauma patient management. J Trauma. 2006;60(4):785-791. doi:10.1097/01.ta.0000214583.21492.e8

4.    Shokoohi H, Boniface KS, Pourmand A, et al. Bedside Ultrasound Reduces Diagnostic Uncertainty and Guides Resuscitation in Patients With Undifferentiated Hypotension. Crit Care Med. 2015;43(12):2562-2569. doi:10.1097/CCM.0000000000001285

5.     Zanobetti, Scorpiniti, M., Gigli, C., Nazerian, P., Vanni, S., Innocenti, F., Stefanone, V. T., Savinelli, C., Coppa, A., Bigiarini, S., Caldi, F., Tassinari, I., Conti, A., Grifoni, S., & Pini, R. (2017). Point-of-Care Ultrasonography for Evaluation of Acute Dyspnea in the ED. Chest, 151(6), 1295–1301. https://doi.org/10.1016/j.chest.2017.02.003

6.    Durgun Y, Yurumez Y, Guner NG, Aslan N, Durmus E, Kahraman Y. Abdominal Pain Management and Point-of-care Ultrasound in the Emergency Department: A Randomised, Prospective, Controlled Study. J Coll Physicians Surg Pak. 2022;32(10):1260-1265. doi:10.29271/jcpsp.2022.10.1260

7.    Perazzo A, Gatto P, Barlascini C, Ferrari-Bravo M, Nicolini A. Can ultrasound guidance reduce the risk of pneumothorax following thoracentesis? . J Bras Pneumol. 2014;40(1):6-12. doi:10.1590/S1806-37132014000100002

8.    Brass P, Hellmich M, Kolodziej L, Schick G, Smith AF. Ultrasound guidance versus anatomical landmarks for internal jugular vein catheterization. Cochrane Database Syst Rev. 2015;1(1):CD006962. Published 2015 Jan 9. doi:10.1002/14651858.CD006962.pub2

9.    Andersen CA, Brodersen J, Rudbæk TR, Jensen MB. Patients' experiences of the use of point-of-care ultrasound in general practice - a cross-sectional study. BMC Fam Pract. 2021;22(1):116. Published 2021 Jun 18. doi:10.1186/s12875-021-01459-z