Description and evaluation of an internal medicine diagnostic and procedural POCUS service

Introduction: Point-of-care ultrasound (POCUS) is a technology with increasing utility and uptake in internal medicine (IM). While the majority of POCUS is performed by the treating clinician themselves, there is an evolving niche for expert-level POCUS users to act as consultants for diagnostic or procedural POCUS questions. There is minimal existing literature surrounding these types of consultant services. Methods: This was a retrospective service audit of an IM consultative POCUS team at an academic quaternary care hospital. The total number of scans, exam types, and quality assurance compliance was extracted from a POCUS-specific archiving system for a 12-month period. Individual reports from the POCUS team were reviewed from a 6-month period to examine clinical impact. Results: Over a 12-month period, 2010 POCUS exams were performed, with an average of 8.0 scans per workday. Of these, 1071 (53.3%) were reported on an archiving platform, and 810 (75.6%) of reported scans completed quality assurance review. Over a 6-month period, the IM POCUS service reported a total of 437 scans. The majority ( n = 272, 62.2%) were diagnostic scans, with the most common exam type being volume status assessments (33.6%). Of all consults, 82.8% led to a change in clinical management. Discussion: We describe a novel diagnostic and procedural IM POCUS consultative service. Benefits of this type of service include wider access to POCUS expertise for complex patients who benefit from detailed multi-organ assessments, expedited procedures, potential cost savings, and increased procedural and ultrasound exposure for trainees.