Background: Point-of-care ultrasound (POCUS) has emerged as a valuable tool for rapid diagnosis, procedural guidance, and real-time clinical decision-making in neonatal and pediatric critical care. Despite its growing use in acute medicine, the evidence describing its implementation, utility, and impact in interfacility and prehospital transport settings remains limited. This scoping review aims to systematically map the current body of evidence on POCUS use during neonatal and pediatric transport and to identify knowledge gaps to inform future research, training, and clinical integration. Methods: A scoping review was conducted following PRISMA-ScR 2020 guidelines, searching PubMed, Embase, Scopus, CINAHL, and Web of Science for studies describing POCUS use during neonatal and pediatric transport. Results: Of 3676 unique articles identified, 20 met inclusion criteria, including 10 cohort studies, 3 case series, 4 case reports, 2 narrative reviews, and 1 textbook chapter. Fifteen studies reported extractable patient-level data and were included in quantitative synthesis, encompassing 4278 patients. Among these, 1153 (27.0%) patients were under 18 years old, and 576 (13.5%) had POCUS performed during transport. POCUS was primarily used for diagnostic assessment—mainly lung and cardiac imaging—with variability in protocols, operator training, and transport characteristics. Eleven studies (73.3%) reported that POCUS altered clinical management, influencing management in 106 (18.4%) patients through diagnostic clarification, resuscitation decisions, medical or ventilator adjustments, and changes in transport destination. Conclusions: Evidence suggests that POCUS supports clinical decision-making and timely intervention during neonatal and pediatric transport, though use remains inconsistent. Future studies should focus on developing structured training frameworks, validating transport-specific protocols, and assessing the impact of POCUS on clinical outcomes and transport safety.

Esophageal button battery impactions are pediatric emergencies with clear guidelines for pre-extraction management, but post-extraction care remains highly variable. Common practices include ICU admission, prolonged NPO, antibiotics, and extensive imaging, though the supporting evidence is unclear. We performed a scoping review, searching PubMed, Embase, and Scopus for pediatric esophageal button battery injuries reporting post-extraction management. Variables included imaging strategy and impact, ICU admission, feeding practices, and complications. Case reports, case series, and retrospective cohorts were included. Variables included imaging strategy and impact, ICU admission, feeding practices, and complications. Case reports, case series, and retrospective cohorts were included. Of 37 studies with 713 patients, complications included 47 esophageal perforations, 37 tracheoesophageal fistulas, 28 esophageal strictures, 26 mediastinitis, 23 esophageal stenoses, 11 vocal cord injuries, 4 aortoesophageal fistulas, and 3 deaths. Post-extraction imaging was reported in 83.8 % of studies with 610 patients; esophagram was most common. In studies that reported imaging details, imaging influenced postoperative management in 12/23 studies using esophagram, 5/12 studies using CXR, 4/6 studies using CT, and 2/3 studies using MRI/MRA. (These were study-level proportions as patient-level counts could not be consistently extracted and modalities overlapped).Time to feeding ranged from 1 h to 233 days via multiple routes. Among 24 studies with known timing, 12/18 resuming <7 days and 2/6 resuming ≥7 days reported morbidity or mortality. Antibiotics were explicitly given in 24 studies. Routine ICU admission, prolonged NPO, universal antibiotics, and multi-modality imaging are not standard after esophageal button battery removal. We propose a risk-stratified framework for imaging, ICU use, and feeding that reserves advanced imaging, ICU level care, and delayed feedings for patients at highest risk for complications based on their presentation and injury severity.