POINT-OF-CARE ULTRASOUND (POCUS) IN DIAGNOSTIC DEFINITION AND IMMEDIATE MANAGEMENT OF CRITICAL PATIENTS: AN EXPERIENCE REPORT

Abstract

Point-of-Care Ultrasound (POCUS) has established itself as the 21st-century visual stethoscope in critical scenarios. This hybrid study evaluated the relevance of POCUS in diagnostic accuracy and immediate management of acute patients by integrating a systematic review (PECO framework, PRISMA guidelines, NOS scale, and GRADE system) with an experience report from an ICU in Anápolis, Brazil. Synthesis of 10 included primary studies demonstrated a diagnostic impact in 82% of cases and management changes in 47% of critical patients, saving approximately 100 minutes in definitive diagnosis workflow. Practically, systematic bedside cervical insonation identified the 'thyroid inferno' sign, resolving a severe thyrotoxic crisis mimicking refractory status epilepticus in a deeply sedated patient, allowing targeted therapy and successful extubation within 48 hours. POCUS represents the fifth pillar of physical examination, essential for reducing clinical uncertainty and optimizing patient safety.