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. 2023 Dec 21;14(1):17.
doi: 10.3390/diagnostics14010017.

The Performance Characteristics of Handheld, Non-Piezoelectric Point-of-Care Ultrasound (POCUS) in the Emergency Department

Brandon Michael Wubben  1 , Hae In Yun  2
Affiliations

The Performance Characteristics of Handheld, Non-Piezoelectric Point-of-Care Ultrasound (POCUS) in the Emergency Department

Brandon Michael Wubben et al. Diagnostics (Basel). .

Abstract

The use of handheld point-of-care ultrasound (HH-POCUS) platforms is rapidly increasing, but the diagnostic performance of HH-POCUS in the emergency department (ED) has not been well-studied. For a period of one year, only a HH-POCUS system that uses a non-piezoelectric array (Butterfly iQ+™) was available for clinical POCUS examinations in our ED. We performed a retrospective observational study of patients who underwent cardiac, thoracic, renal, biliary, or lower extremity venous (DVT) examinations from November 2021-November 2022 and calculated performance characteristics of HH-POCUS relative to radiology imaging. A total of 381 HH-POCUS studies were evaluated. Cardiac image quality was significantly lower than lung (p = 0.002). Over half of the studies (213/381) had imaging available for comparison, and HH-POCUS identified 86.5% (32/37, (95%CI) 70.4-94.9) of prespecified emergent diagnoses, including acute cholecystitis, severely reduced left ventricular ejection fraction, pericardial effusion or tamponade, moderate or larger pleural effusion, pneumothorax, moderate or larger hydronephrosis, and DVT. For less emergent diagnoses, 84.3% (43/51, (95%CI) 70.9-92.5) were identified. Overall, HH-POCUS using a non-piezoelectric array showed modest real-world performance in the ED for cardiac, thoracic, renal, biliary, and DVT examinations. HH-POCUS may be inadequate to rule out some common ED diagnoses, but had good specificity for certain conditions such as pericardial effusion.

Keywords: cholecystitis; echocardiography; emergency medicine; handheld; hydronephrosis; non-piezoelectric; pleural effusion; point-of-care ultrasound.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Inclusion diagram for emergency department handheld point-of-care (HH-POCUS) images matched with consultative imaging results. (a) Includes two cases where consultative imaging and POCUS were both indeterminate for pleural effusion.
Figure 2
Figure 2
Example images obtained with the Butterfly iQ+ platform: (a) normal cardiac parasternal long axis view; (b) normal renal long axis view.
See this image and copyright information in PMC

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