POINT-OF-CARE ULTRASOUND IN INTERNAL MEDICINE: CLINICAL APPLICATIONS, HEMODYNAMIC ASSESSMENT, AND IMPLEMENTATION- A Review

Abstract

Point-of-care ultrasound (POCUS) has become an essential tool in the internal medicine setting, enabling rapid, focused and non-invasive evaluation and supplementing traditional clinical evaluations. This narrative review aims to highlight the state-of-the-art knowledge on the clinical use, hemodynamic evaluation, implementation strategies and future perspectives of POCUS in internal medicine. The review highlights 4 high-yield applications: Lung ultrasound, Focused Cardiac Ultrasound (FoCUS), Rapid Ultrasound in Shock (RUSH) protocol, Venous Excess Ultrasound (VExUS) framework for venous congestion assessment. These methods allow clinician to quickly assess patients with dyspnea, hypotension, heart failure, acute kidney injury and undifferentiated shock, which increases the diagnostic accuracy, helps guide therapy, and simplifies serial bedside evaluation. It also addresses how POCUS has become more integrated into outpatient and ward-based settings, competency-based training, credentialing, documentation, quality assurance, and the new technologies, including handheld ultrasound, tele-ultrasound, and artificial intelligence image analysis. While highly operator dependent and not a replacement for comprehensive diagnostic imaging, POCUS can be incorporated into the routine practice of internal medicine to help inform clinical decisions at the bedside, effectively using resources, and improving outcomes for the patient through timely and evidence-based decision-making.