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. 2025 Nov 19;17(1):60.
doi: 10.1186/s13089-025-00463-z.

Feasibility of point-of-care ultrasound during the emergency department triage: a prospective cohort study

Davide Enrici Baion  1 , Chiara Schettino  1 , Lara Vita  1 , Deborah Luison  1 , Stefania Caprioli  1 , Matteo Lombardo  1 , Alberto La Ferrara  1 , Francesca Locascio  1 , Emanuela Galluzzo  1 , Vittoria Ciampi  1 , Aurora Ianiro  2 , Davide Maserin  1 , Francesco Malara  1 , Noemi Urso  1 , Fulvio Morello  1   3 , Daniele Marchisio  4 , Enrico Lupia  1   3 , Emanuele Pivetta  5   6
Affiliations

Feasibility of point-of-care ultrasound during the emergency department triage: a prospective cohort study

Davide Enrici Baion et al. Ultrasound J. .

Abstract

Background: The primary aim of this study was to evaluate the feasibility of adding point-of-care ultrasound (POCUS) during the Emergency Department (ED) triage process. This prospective study enrolled two cohorts of adult patients presenting to the ED for a selected group of acute symptoms, previously selected on the basis of the presumed utility of POCUS during triage evaluation. The ED triage process was performed as recommended by the hospital guidelines or by including a nurse-performed POCUS evaluation. Only urgent or less codes were considered eligible for the study. The timing of all evaluations was recorded along with the opinion of the nurses involved in the study on the impact of POCUS results on the triage process. After ED discharge, the most appropriate triage code was determined by independent review of the triage data.

Results: A total of 312 patients were enrolled, 101 of whom were evaluated with the hospital standard triage process. Nine nurses with expertise in both ED triage and POCUS were involved in the study. The majority of the enrolled patients were deferrable or minor urgency (about 60% in both groups). The median time needed for the triage evaluation was 180 seconds (range 540), 90 seconds longer in the POCUS group than in the standard triage group (p < 0.01). Net reclassification index of POCUS-implemented compared with standard triage protocol was 8% and 5% for urgent and less urgent cases.

Conclusions: This small single site study suggests that POCUS is feasible during the ED triage and it is potentially useful by triage nurses. However, future studies are needed to confirm POCUS potential usefulness for a more accurate triage process.

Keywords: Emergency department; Nursing; Point-of-care ultrasound; Triage.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: This was a cross-sectional observational study following the Helsinki Declaration and approved by the institutional review board. Written informed consent was obtained from all enrolled patients. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Symptoms included in the study and corresponding point-of-care ultrasound (POCUS) evaluations. POCUS, point-of-care ultrasound; LUS, lung ultrasound (i.e., sliding and lung bases); CUS, compression ultrasonography of leg veins; evaluation of the abdominal aorta included 3 transverse scans and a proximal longitudinal view; abdomen refers to an evaluation similar to the eFAST (extended focused assessment sonography for trauma) scan, for ruling out presence of free fluid; pelvis for IUP (intrauterine pregnancy), evaluation of the pelvis for assessing the presence of a first trimester intrauterine pregnancy; pelvis for measuring bladder refers to a 2-view measurement of the bladder (two transverse diameters, and a longitudinal one). IVC: inferior vena cava. * The LUS evaluation did not include the assessment of changes in parenchymal density (i.e., the presence of B-lines)
Fig. 2
Fig. 2
Flow chart of patient enrollment in the POCUS evaluation group POCUS point-of-care ultrasound
See this image and copyright information in PMC

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