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It is clear that POCUS is often under documented and under billed and this can have medicolegal risks, as well as significant revenue loss. The time required to order the study in the EHR, upload the images, and then document in the EHR can be time-consuming and is a commonly cited reason by physicians as the reason they did not document the examination. Simple solutions could include sending an email reminder to the physician but this study demonstrated limited durability to a single e-mail reminder as an intervention to improve POCUS documentation in the ED.


Read the full article at PubMed:
https://pmc.ncbi.nlm.nih.gov/articles/PMC12161696/

This study is limited by the fact that it is a single center study and involves a small number of study participants, but it brings up some interesting points. Many would consider determining the presence or absence of lung sliding to be a very basic POCUS skill. It is interesting that the interrater agreement, determined by an ICC was 0.44 for B-mode and 0.43 for M-mode. A limitation could be that the study participants did not have the ability to adjust the machine settings or to scan adjacent areas. Further studies will need to be done to determine solutions—? Perform both B-mode and M-mode before making diagnosis. ? Use of AI. ? Increase minimum number of studies performed before credentialing.

Read the full article on POCUS Journal: https://doi.org/10.24908/pocusj.v10i01.17807

This study, while limited by its retrospective design, has drawn similar conclusions to what has been found in the anesthesiology literature, but further studies will need to be done to see if there are unique outcome differences in the ED setting using prospective studies. They found that dexamethasone had an association with improved pain control within 60 minutes without additional safety concerns. Dexamethasone is a well supported adjuvant for peripheral nerve blocks, prolonging analgesia and reducing rebound pain and opioid use based on studies in the anesthesiology literature. It is important to keep in mind that dexamethasone can be administered intravenously or perineurally with intravenous administration offering comparable efficacy at higher doses and a more established safety profile based on those anesthesiology studies.

Read the full article on POCUS Journal: https://pubmed.ncbi.nlm.nih.gov/40873157

This JAMA Network Open study asked whether POCUS for patients admitted with undifferentiated dyspnea could shorten hospital stays and cut costs.

At a single academic center, hospitalists got one-on-one training and did a 6-view cardiac and an 8-zone lung POCUS on day one of admission, backed up by sonographers with remote cardiologist interpretation. They found that POCUS patients had about a 30% shorter length of stay, saving nearly $750k in bed-day costs.

However, 80% of scans were done by sonographers, not hospitalists—so it’s hard to see this working outside a well-resourced tertiary academic center. Hospitalists cited lack of training, limited time on rounds, and no real incentives to incorporate POCUS as barriers.

Seamless integration of cardiopulmonary POCUS into hospitalist practice will require better, more longitudinal training, workflow integration, and institutional buy-in.

In conclusion, this study highlights POCUS as a promising tool to shorten hospital stays and lower costs, pointing to real opportunities if training and integration improve, however, adoption in smaller, less well-resourced hospitals may not show the same results.

Read the full article here:
https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2838514

It is clear that POCUS is a critical skill in emergency medicine, as well as numerous other specialties. How to best implement POCUS into training programs has been a source of debate. Most programs emphasize early integration with intern bootcamps as well as a 2-4 week intern POCUS rotation. It is important to keep in mind that POCUS is a perishable skill (both interpretive and performance). The current ACEP Ultrasound Guidelines highlights the point that an intern rotation is not enough and continued POCUS education is needed throughout residency. This study found that a structured longitudinal ultrasound curriculum during senior residency meaningfully increases scan volume without compromising examination accuracy, supporting its adoption as a feasible strategy to reinforce POCUS competency. If you are training residents in POCUS, ensure that their POCUS didactic training extends beyond the intern year.

Read the full article here:
https://pubmed.ncbi.nlm.nih.gov/41035713