USE OF POINT OF CARE POCUS IN THE DIAGNOSIS OF SHOCK IN CRITICALLY ILL PATIENTS IN THE EMERGENCY ROOM
Abstract
The study addresses the use of point-of-care ultrasound (POCUS) as an immediate diagnostic tool in the care of critically ill patients in emergency shock situations. The research is based on the need to understand how POCUS contributes to the rapid diagnostic evaluation and clinical management of these patients, given the limitations of conventional methods, such as radiography and laboratory tests, which require more time and travel. The objective of this study was to investigate the contribution of POCUS to diagnostic accuracy and clinical decision-making in emergencies. The investigation was conducted through a systematic review of qualitative literature, based on the survey, organization and critical analysis of scientific productions published in the last five years. The PubMed, Medline and CAPES Journals databases were consulted, totaling 3,178 records initially identified, of which only 15 met the defined methodological and thematic criteria, composing the final corpus of analysis. The results indicate that POCUS has high sensitivity and specificity in the detection of critical conditions such as cardiac tamponade, pulmonary embolism, hypovolemic and obstructive shock, surpassing traditional methods in response time, cost and safety. It is concluded that POCUS is consolidated as an indispensable tool in emergency practice, as it combines speed, precision and safety, configuring itself as an extension of the physical examination and an essential element in immediate therapeutic decision-making. The study contributes to scientific advancement by reinforcing the importance of the systematic incorporation of POCUS in emergency protocols, promoting diagnostic efficiency and equity in hospital care.
Author Biography
Medical student at the Municipal University of São Caetano do Sul, surgical instrument technician, and registered nurse with experience in medical clinics, surgical clinics, and intensive care units (ICU). Postgraduate in Intensive Care and Emergency and Urgent Care from Albert Einstein, with ACLS and BLS certifications from the American Heart Association.
References
BILOURO, Marcella Alves de Menezes et al. Os benefícios do Ultrassom Point-of-care (POCUS) na emergência. Revista Eletrônica Acervo Saúde, v. 24, n. 4, p. 1-8, 2024. Disponível em: https://acervomais.com.br/index.php/saude/article/view/15458 Acesso em: 04 ago. 2025. DOI: https://doi.org/10.25248/reas.e15458.2024
COSTA, Giovani Davanço. O uso de ultrassom à beira leito (POCUS) na emergência: uma revisão bibliográfica. Cuadernos de Educación y Desarrollo, v. 16, n. 12, p. 1-4, 2024. Disponível em: https://ojs.cuadernoseducacion.com/ojs/index.php/ced/article/view/6639 Acesso em: 04 ago. 2025. DOI: https://doi.org/10.55905/cuadv16n12-134
GARCIA, Lara do Norte.; RODRIGUES, Matheus.; OLIVEIRA, Amorim de. Paciente com dispneia aguda. Revista SOCESP: Sociedade de Cardiologia do Estado de São Paulo, v. 34, n. 2, p. 108-112, 2024. Disponível em: https://socesp.org.br/revista/pdfjs/web/viewer.html?arquivo=5ec146aa2d58d4d4106149d569d8c683.pdf&edicoes=1 Acesso em: 04 ago. 2025. DOI: https://doi.org/10.29381/0103-8559/20243402108-12
GIL, Antonio Carlos. Métodos e técnicas de pesquisa social. 6. ed. São Paulo: Atlas, 2008.
LAU, Yie Hui; SEE, Kay Choong. Point-of-care ultrasound for critically-ill patients: a mini-review of key diagnostic features and protocols. World Journal of Critical Care Medicine, v. 11, n. 2, p. 70-84, 2022. Disponível em: https://pmc.ncbi.nlm.nih.gov/articles/PMC8968483/ Acesso em: 04 ago. 2025. DOI: https://doi.org/10.5492/wjccm.v11.i2.70
LENTZ, Brian et al. A systematic review of the cost-effectiveness of ultrasound in emergency care settings. The Ultrasound Journal, v. 13, n. 1, p. 1-9, 2021. Disponível em: https://link.springer.com/article/10.1186/s13089-021-00216-8 Acesso em: 04 ago. 2025. DOI: https://doi.org/10.1186/s13089-021-00216-8
LIN, Judy et al. Point-of-care ultrasound in airway evaluation and management: a comprehensive review. Diagnostics, v. 13, n. 9, p. 1-26, 2023. Disponível em: https://www.mdpi.com/2075-4418/13/9/1541 Acesso em: 04 ago. 2025. DOI: https://doi.org/10.3390/diagnostics13091541
LIU, Quanle et al. Effectiveness of a multi-model teaching strategy to train emergency medicine residents to use point-of-care ultrasound (POCUS) for assessment of shock. BMC Medical Education, v. 25, n. 1, p. 1-10, 2025. Disponível em: https://link.springer.com/article/10.1186/s12909-025-07093-y Acesso em: 04 ago. 2025. DOI: https://doi.org/10.1186/s12909-025-07093-y
LUSVARGHI, Enzo Fabrizzio Moretto et al. Eficácia da ultrassonografia point-of-care no diagnóstico de tamponamento cardíaco em traumas torácicos penetrantes: uma revisão sistemática e metanálise. Contribuciones a las Ciencias Sociales, v.17, n.13, p. 1-14, 2024. Disponível em: https://ojs.revistacontribuciones.com/ojs/index.php/clcs/article/view/14103 Acesso em: 04 ago. 2025. DOI: https://doi.org/10.55905/revconv.17n.13-500
MARCONI, Marina de Andrade; LAKATOS, Eva Maria. Fundamentos de metodologia científica. 8. ed. São Paulo: Atlas, 2017.
MELO, Rafael Hortêncio et al. Diagnostic accuracy of multi-organ point-of-care ultrasound for pulmonary embolism in critically ill patients: a systematic review and meta-analysis. Critical Care, v. 29, n. 1, p. 1-10, 2025. Disponível em: https://link.springer.com/article/10.1186/s13054-025-05359-x Acesso em: 04 ago. 2025. DOI: https://doi.org/10.1186/s13054-025-05359-x
NTI, Benjamin et al. Artificial intelligence‐augmented pediatric lung POCUS: a pilot study of novice learners. Journal of Ultrasound in Medicine, v. 41, n. 12, p. 2965-2972, 2022. Disponível em: https://onlinelibrary.wiley.com/doi/abs/10.1002/jum.15992 Acesso em: 04 ago. 2025. DOI: https://doi.org/10.1002/jum.15992
RAQUEL, Flavia et al. Utilização da ultrassonografia Point-of-Care (POCUS) na avaliação inicial do paciente com choque indiferenciado na sala de emergência. Revista Ibero-Americana de Humanidades, Ciências e Educação, v. 11, n. 4, p. 2691-2699, 2025. Disponível em: https://periodicorease.pro.br/rease/article/view/18860 Acesso em: 04 ago. 2025. DOI: https://doi.org/10.51891/rease.v11i4.18860
ROCHA, Miriam Marques Nogueira et al. Ultrassonografia point-of-care no departamento de emergência: diagnóstico de complicação mecânica após infarto agudo do miocárdio. Brazilian Journal of Health Review, v. 6, n. 6, p. 33571-33579, 2023. Disponível em: https://ojs.brazilianjournals.com.br/ojs/index.php/BJHR/article/view/65994 Acesso em: 04 ago. 2025. DOI: https://doi.org/10.34119/bjhrv6n6-541
SPAMPINATO, Michele Domenico et al. Diagnostic accuracy of point of care ultrasound (POCUS) in clinical practice: a retrospective, emergency department based study. Journal of Clinical Ultrasound, v. 52, n. 3, p. 255-264, 2024. Disponível em: https://onlinelibrary.wiley.com/doi/abs/10.1002/jcu.23619 Acesso em: 04 ago. 2025. DOI: https://doi.org/10.1002/jcu.23619
YOSHIDA, Takuo et al. Diagnostic accuracy of point-of-care ultrasound for shock: a systematic review and meta-analysis. Critical Care, v. 27, n. 1, p. 1-11, 2023. Disponível em: https://link.springer.com/article/10.1186/s13054-023-04495-6?fbclid=IwAR2BVL2arfk0qBRymn6mkolfMq9NuahecQfbDrzbWCTYfM0yiKVls1Mu5Ns Acesso em: 04 ago. 2025.
ZAMANI, Marjon; FURST, Ariel L.; KLAPPERICH, Catherine M. Strategies for engineering affordable technologies for point-of-care diagnostics of infectious diseases. Accounts of Chemical Research, v. 54, n. 20, p. 3772-3779, 2021. Disponível em: https://pubs.acs.org/doi/abs/10.1021/acs.accounts.1c00434 Acesso em: 04 ago. 2025. DOI: https://doi.org/10.1021/acs.accounts.1c00434
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