THE APPLICATION OF POCUS IN THE INITIAL ASSESSMENT OF THE CRITICALLY ILL PATIENT: IMPACT ON EMERGENCY DECISION-MAKING

Abstract

The initial assessment of critically ill patients in emergency and intensive care settings poses complex challenges due to the urgent need for rapid and accurate diagnoses. Traditionally based on physical examination and conventional imaging studies that demand time and patient transport, the diagnostic approach has been optimized by the incorporation of point-of-care ultrasonography (POCUS). The objective of this study was to analyze the role of POCUS in the initial evaluation of critically ill patients in emergency scenarios, emphasizing its impact on clinical decision-making, indications, diagnostic accuracy, and care limitations. To this end, an integrative literature review with a qualitative approach was conducted, based on systematic searches in the PubMed and Virtual Health Library (BVS) databases in March 2026, selecting 8 studies published between 2021 and 2026. The results indicate that POCUS plays a central multisystemic role in the hemodynamic, respiratory, abdominal, and vascular spheres, enabling rapid etiological differentiation of shocks and acute dysfunctions through structured protocols (such as FAST/eFAST, RUSH, BLUE, and FATE). Its applicability is directly related to reduced diagnostic time and immediate modifications in therapeutic management. However, the method presents clear technical limitations, highlighted by strong operator dependence and acoustic window restrictions inherent to the patient's biotype. It is concluded that POCUS establishes itself as an indispensable complementary tool in the emergency environment, whose success depends on structured training programs and an inseparable integration into traditional clinical reasoning.