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ESR statement on portable ultrasound devices

  • Portable US devices could be indicated for abdominal, cardiac, lung, obstetric, paediatric, vascular, and trauma scanning

  • Portable US devices can be used by different healthcare professionals.

  • Portable US devices can be associated with the use of different ultrasound techniques such as colour Doppler US and PW-Doppler.

  • Portable devices can considerably reduce the overall time required for performing an ultrasound examination at the bedside.

  • Portable US devices are effective in the hands of experienced examiners but will not replace a high-resolution US examination.

  • Patient safety and high standards of hygiene must be maintained.

  • Adequate image and report storage are mandatory.

 

Portable and handheld Ultrasound (US) devices are being used increasingly in clinical practice today. Their use is particularly important in situations where time is of the essence (emergency room, intensive care), or the location favours portable devices (remote locations, doctor’s office, etc.). Regardless of the circumstances, adequate user training and competent use of the device are essential. Furthermore, the use of these devices requires protocols for decontamination and data protection – in relation to data collection, transmission, and confidentiality. Overall, the quality of the devices tested and reported on in this report allows responsible clinical use of the devices.

PUDs are mainly used in a small number of clinical specialties and situations. One major field is trauma medicine since ultrasound devices are directly accessible, non-invasive, and inexpensive. The focused assessment with sonography for trauma (FAST) is a crucial component of the trauma care algorithm to assess pericardial or pleural effusions, free intraabdominal blood, and also pneumothoraces. Furthermore, ultrasound helps to identify haemodynamically unstable patients by assessing the status of the inferior vena cava (IVC). As ultrasound devices are getting smaller and portable, in the pre-hospital setting they help the rapid evaluation and triage of victims, e.g. in the context of a mass casualty incident (MCI). A proposed protocol for a comprehensive ultrasound evaluation of MCI victims is the so-called “CAVEAT” exam – chest-abdomen-vena cava or vascular extremity in acute triage [7]. More advanced technologies will guarantee rapid transfer of the point-of-care ultrasound findings to receiving hospitals to provide best medical care.

In several studies, PUD performed efficiently as a tool for screening for abdominal aortic aneurysms in the outpatient setting , and proved promising when used by different health care providers (nurses, physical therapists, and physicians) in the assessment of haemarthrosis in haemophiliac patients 

A substantial proportion of American rheumatologists routinely use point of care ultrasound (POCUS) to evaluate joint effusions and erosions and abnormalities of the tendons

In addition, PUD proved to be suitable for detecting intrahepatic ductal stones, gallstones, hydronephrosis, and also for volume assessment in patients on haemodialysis or those with acute kidney failure

Besides diagnostic use, portable ultrasound devices were reported to be a feasible guiding tool for interventions, e.g., aspiration/drainage of ascites  central venous cannulations, thoracocentesis, or pericardiocentesis 

Portable US immediately after MD-CT helps to narrow down the differential diagnosis of hepatic and pleural lesions with minimal additional effort in time and organisation 

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