Point-of-Care-Ultraschall im Schockraum

Point-of-care ultrasound (POCUS) is an established tool in emergency medicine (EM) that enables real-time diagnostics. It is performed bedside by the EM physician and is available in almost every resuscitation room. For critically ill patients, rapid diagnosis is crucial to initiate targeted therapy. POCUS can reduce the time to diagnosis and, thereby, shorten the length of stay in the resuscitation room. Structured application following the ABCDE scheme offers various uses. Airway (A): POCUS helps confirm endotracheal tube placement in intubated patients and can visualize anatomical landmarks for emergency cricothyrotomy. Breathing (B): Structured thoracic ultrasound can narrow down differential diagnoses and avoid unnecessary chest X‑rays. Circulation (C): In a state of shock, POCUS is an important diagnostic tool. It is used to differentiate between hypovolemic, obstructive, and cardiogenic shock and to identify the cause of hemodynamic instability. During resuscitation, POCUS can reveal reversible causes such as pericardial effusion or right heart strain and distinguish between pseudo-PEA and real PEA (pulseless electrical activity). Disability (D): POCUS allows noninvasive assessment of elevated intracranial pressure. Exposure (E): Ultrasonography is used for guidance of a variety of invasive procedures that are required in the treatment of critically ill patients.