Over 350,000 patients experience out-of-hospital cardiac arrest annually in the United States. Patients presenting to the emergency department (ED) in cardiac arrest are critically ill and require emergent clinical decisions and treatment. Point-of-care ultrasound (POCUS) is useful as a rapid, bedside diagnostic imaging tool to help elucidate possible causes of cardiac arrest and guide management. Using a validated systematic approach such as the SHoC and CASA protocols, clinicians can safely perform POCUS with shortened pauses during pulse checks. POCUS is key in evaluating cardiac arrhythmias such as ventricular fibrillation (VF), which has higher survival rates with defibrillation, versus cardiac standstill, which has higher mortality per recent research studies. When performed by experienced users, POCUS also facilitates identification of reversible causes for improved cardiac arrest patient outcomes and can guide decisions in resuscitative efforts. In summary, this manuscript is a narrative review that illustrates identifiable POCUS findings and synthesizes them to guide potential emergent intervention in patients in cardiac arrest including: ventricular fibrillation, cardiac standstill, pericardial effusion, cardiac tamponade, right heart strain such as from acute pulmonary embolism, reduced cardiac function, wall motion abnormality, ruptured ventricular pseudoaneurysm, and aortic dissection.

Abdominal pain is a common presentation in the emergency department (ED). Ultrasound is the first-line diagnostic imaging modality for right upper quadrant pain. Point-of-care ultrasound (POCUS) is a focused examination that can be performed at the patient’s bedside to evaluate acute and emergent biliary pathology. The advantages of POCUS include avoiding the potential safety risks associated with transporting critically ill patients, no exposure to ionizing radiation, potentially reduced costs, and rapid diagnosis. This narrative review synthesizes key sonographic findings and techniques for emergent and non-emergent biliary diseases that physicians should recognize at first glance. We present significant and interesting images of cholelithiasis, acute cholecystitis, emphysematous gallbladder, choledocholithiasis or sludge, Mirizzi syndrome, post-operative biliary obstruction, gallbladder polyps, biliary neoplasms, and malignant-appearing lesions or masses. Finally, this review integrates POCUS into clinical pathways to guide decisions regarding additional abdominal imaging, such as computed tomography or radiology-performed ultrasound, and surgical consultation.

Introduction: Point-of-care ultrasound (POCUS) is a rapid bedside tool, particularly in undifferentiated emergency department patients. Point-of-care ultrasound can investigate potential intra-abdominal infections in febrile patients, especially in the elderly, who often present atypically without abdominal pain or localizing symptoms. Case Report: We highlight the important POCUS findings of cholecystoduodenal fistula and staghorn calculus in a febrile, elderly patient with dementia. Conclusion: Early recognition of cholecystoduodenal fistula and staghorn calculus using POCUS can expedite appropriate antibiotic and interventional treatment for improved patient outcomes.