Pre-hospital and emergency department point-of-care ultrasound in cardiovascular emergencies: a scoping review
Abstract
Background: Point-of-care ultrasound (POCUS) is integral to emergency department (ED) and pre-hospital medicine, yet evidence comparing its diagnostic and operational performance across environments remains fragmented, especially in cardiovascular emergencies. This review aimed to evaluate and compare the diagnostic performance, workflow impact, and clinical influence of POCUS for six major cardiovascular emergencies across pre-hospital and ED settings, while examining the effects of operator training, device technology, and governance structures.
Methods: A structured scoping review search was conducted using multiple electronic databases to identify adult studies evaluating pre-hospital or ED POCUS in cardiac arrest, cardiac tamponade, acute heart failure, shock, pneumothorax, and aortic dissection. Eligible designs included randomised, prospective, and observational studies reporting diagnostic accuracy, process efficiency, management impact, or outcomes. Data were synthesised comparatively rather than pooled.
Results: ED POCUS demonstrated high diagnostic accuracy (typically >85-90%) and shortened time to diagnosis or intervention by 30-70 minutes in acute heart failure, pneumothorax, tamponade, and dissection representing meaningful process improvements. However, as seen in conditions like undifferentiated shock, these process gains do not consistently translate into improved patient-centred outcomes such as survival or reduced hospital length of stay. Pre-hospital…
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