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Welcome to POCUS25

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Contribute to the scientific development of a list of the top 25 point-of-care ultrasound (POCUS) procedures and protocols used globally—the POCUS25. As a POCUS users you can participate in the POCUS25 Survey and be part of a psychometrically validated list that will support the ever-growing needs of the POCUS community.

Help us take the POCUS25 from development to a global reality!

The POCUS25 list will be used to:
  • bring clarity to the scope of the core POCUS practices globally
  • provide guidance for education and training on these core practices
  • improve global health through better access to ultrasound practices in the point-of-care setting

Below is an initial list of 25 point-of-care ultrasound practices that have been identified as the core POCUS skills and have the potential to improve global health.

You can help!

We are actively seeking feedback from the POCUS community to refine this list.

Please respond to this survey to give us your input about important POCUS practices.

Check out our POCUS25 blog post here.

# Icon POCUS Procedure or Protocol
1 Deep Vein Thrombosis (DVT)—Lower extremity 2 zone compression test using B-mode only—saphenofemoral junction region and popliteal
2 Focused Cardiac Ultrasound (FoCUS)—PLAX, PSAX, A4C, A4C—ASE recommendation
3 Gross estimation of LV and RV systolic function—EPSS, contractility of LV and RV extremes of volume status
4 Pericardial effusion and cardiac tamponade detection and differentiation from pleural effusion, assess IVC to support cardiac tamponade findings
5 Extremes of volume status—hypovolemia and hypervolemia using IVC diameter and response to respiration and LV cavity diameter
6 Detection of chronic heart disease (LVH—symmetrical and asymmetrical LVH, RVH and LAE)
7 Normal lung ultrasound—A-lines, etc., lung sliding, lung edge, pleura and rib shadows, pneumonia/consolidation, air bronchogram, dynamic air bronchogram, spine sign
8 Pneumothorax—B-mode and M-mode
9 Pneumonia/consolidation, air bronchogram, dynamic air bronchogram, spine sign, pleural effusion, simple effusion, complex loculated effusion, anechoic and hyperechoic effusion
10 Protocol—EFAST exam
11 Detection of fracture of long bones on B-mode/2D ultrasound or cortical disruption of bones example: rib fracture
12 Knee ultrasound—basic views and detection of knee effusion, ultrasound-guided knee injection and aspiration, anisotropy artifact
13 Liver ultrasound—liver span in the right mid-clavicular plane, fatty liver, liver cyst, liver mass detection, liver abscess
14 Gallbladder ultrasound—gallstones, SIN sign, gallbladder mass, acute cholecystitis and chronic cholecystitis and gangrenous cholecystitis, ultrasound Murphy’s sign, CBD diameter measurement and gross detection of CBD dilatation
15 Pancreas ultrasound, detection of pancreatitis, pancreatic mass, obstruction of CBD by a mass in the region of the head of pancreas or CBD calculus
16 Spleen ultrasound, spleen span measurement, detection of splenic mass and peri splenic fluid
17 AAA screening, technique to measure diameter of abdominal aorta and aortic aneurysm, aortic aneurysm detection, thrombus in an aortic aneurysm and aortic dissection
18 IVC assessment for approximate CVP and volume status
19 KUB ultrasound, renal length measurement, renal calculi, hydronephrosis detection and grading, renal mass, ureteric obstruction, bladder volume, bladder mass
20 Basic practical ultrasound physics and knobology. Modes of ultrasound—B-mode/2D mode, M-mode, color Doppler, power Doppler, spectral Doppler, depth, gain, TGC/DGC, common artifacts
21 Skin and soft tissue ultrasound—normal appearance, edema, cellulitis, abscess
22 Basic female pelvic exam (TAS)—uterus, cervix, ovaries, adnexa, pouch of Douglas/cul de sac
23 Transabdominal female pelvic exam—adnexal mass, ovarian cyst, free fluid in the POD, hydrosalpinx
24 Basic first trimester ultrasound (TAS)—fetal number, fetal cardiac activity, amniotic fluid, intrauterine and extrauterine pregnancy, molar pregnancy, low lying placenta or placenta previa. TVS recommended for ectopic pregnancy if not detectable by TAS
25 MSK—shoulder exam, basic view, ultrasound guided aspiration and injection, anisotropy artifact

POCUS25 FAQ's

The POCUS25 is a core list of the top 25 point-of-care ultrasound (POCUS) practices

  • based on the POCUS community recommendations
  • with potential to improve global health
  • intended for everyone interested in POCUS for their medical practice
  • designed to remain relevant, as it evolves with changes in technology
  • inspired by the Stanford Medicine 25

The POCUS25 page is

  • designed to become a comprehensive resource for education and training on the 25 top ultrasound procedures or protocols

The vision for POCUS25 is to help promote POCUS to all healthcare providers, around the world.

The POCUS25 page will be

  • an online resource about the POCUS25
  • developed collaboratively with the global POCUS community
  • will help make healthcare better
  • improve patient care globally

We believe that POCUS25 will be useful to all healthcare practitioners who

  • assess patients at the point of care—anywhere, anytime
  • have patients with conditions that can quickly diagnose with handheld ultrasound
  • include physicians, a physician assistants, a nurse practitioners, emergency medicine technicians, military doctors, athletic trainers

The need to be proficient in each POCUS25 procedure will be based on the individual healthcare provider’s needs.

  • Primary care physicians may find all of the POCUS25 practices useful.
  • On the other hand, practitioners who see only certain types of patients (e.g., cardiac) may restrict their training to those POCUS practices.

The POCUS25 list will be a “living” document and will evolve over time.

  • Ongoing research and consultation with the global POCUS community will be used to periodically update the POCUS25.

The POCUS25 list is needed to

  • address a lack of clarity in the global medical community about the scope of POCUS
  • bring uniformity and credibility to the POCUS movement

This initial POCUS25 list was developed by

  • the Point-of-Care Ultrasound Certification Academy™’s internal team of clinicians
  • in consultation with approximately 20 subject matter experts in the field of diagnostic ultrasound
  • through a review of published research, manuscripts, society guidelines and recommendations for point-of-care ultrasound

The references provided below were used to develop the initial POCUS25 list. Over time this list will grow, as POCUS25 evolves.

References:

1) Spencer KT, Kimura BJ, Korcarz CE, et al. Focused Cardiac Ultrasound: Recommendations from the American Society of Echocardiography. J Am Soc Echocardiogr. 2013;26:567-81.

2) Ma IWY, Arishenkoff S, Wiseman J, Desy J, Ailon J, Martin L, Otremba M, Halman S, Willemot P, Blouw M, Canadian Internal Medicine Ultrasound (CIMUS) Group (2017) Internal Medicine Point-of-Care Ultrasound Curriculum: Consensus Recommendations from the Canadian Internal Medicine Ultrasound (CIMUS) Group. J Gen Intern Med 32(9):10527

3) Hoppmann RA, Rao VV, Bell F, et al. The Evolution of an Integrated Ultrasound Curriculum (iUSC) for Medical Students: 9-Year Experience. Critical Ultrasound Journal. 2015; 7:18

4) Schnobrich DJ, Gladding S, Olsen AP, Duran-Nelson A (2013) Point-of- Care Ultrasound in Internal Medicine: A National Survey of Educational Leadership. J Grad Med Educ. 5(3):498–502

5)  American College of Emergency Physicians (2017) Ultrasound Guidelines: Emergency, Point-of-Care and Clinical Ultrasound Guidelines in Medicine. Ann Emergency Med 69(5): e27–e54

6) Klem DJ, Ratelle JT, Azeem N, Bonnes SL, Halvorsen AJ, Oxentenko AS et al (2015) Longitudinal Ultrasound Curriculum Improves Long-Term Retention Among Internal Medicine Residents. J Grad Med Educ. 7(3):454–457

7) Kimura BJ, Amundson SA, Phan JN, Agan DL, Shaw DJ (2012) Observations During Development of an Internal Medicine Residency Training Program in Cardiovascular Limited Ultrasound Examination. J Hosp Med. 7(7):537–542  

8) Lewis D, Rang L, Kim D, Robichaud L, Kwan C, Pham C, Shefrin A, Ritcey B, Atkinson P, Woo M, Jelic T, Dallaire, G, Henneberry, R, Turner J, Andani R, Demsey R, Olszynksi P
Recommendations for the Use of Point-of-Care, Ultrasound (POCUS) by Emergency Physicians in Canada,
CJEM.:1-6. doi:10.1017/cem.2019.392

The initial POCUS25 list will be refined through

  • surveying a broad set of POCUS users
    • e.g., physicians, nurse practitioners, sonographers, and other healthcare professionals actively using point-of-care-ultrasound
  • using this feedback, from the above-mentioned POCUS users, to produce an updated POCUS25 list

Our goal is to publish an updated consensus document before the end of 2019, with the voices of all those that participate in the process.

Thank you for your interest in supporting the POCUS25 movement!

You can participate in several ways:
  • complete the POCUS25 survey
  • volunteer to be part of ongoing POCUS25 development efforts
  • join the POCUS Certification Academy’s POCUS Community and share #POCUS25 with your social media network
  • reach out to our team at POCUS@APCA.org

POCUS25

We’d love to get your feedback on the POCUS25







  • Listing you name is optional. If you list your name here, these will be including when sharing your comments.

Thank You to Our POCUS25 Survey Respondents!

  • Yuriy Bronshteyn
  • James DellaValle
  • Robert Kollpainter
  • R. Eugene Zierler
  • Ernesto Brauer
  • Dean Vlahaki
  • David Dawson
  • Hong Wang
  • Ivica Zdravkovic
  • Mohammad Iqbal Afridi
  • Khiliji Faizurrahman
  • Joan Majernik
  • Tere Porcarelli
  • Joseph Pasqualini-Adamo
  • Jonathan Claydon
  • Robert Voelker
  • Rachel Krackov
  • Sarah Constantine
  • Yuyang Tan
  • Daniel Nash
  • Simon Ho
  • Mick Killeen
  • Rozina Badal Munir
  • Dilshad Qureshi
  • Milla Kviatkovsky
  • Daniel Franco Del Aguila
  • Suzanne Poston
  • Cathy Daniels
  • Zainab Mahdi
  • Chris Covert-Bowlds
  • Narinder Virdee
  • Michael Vera
  • Matthew Whittaker
  • Dennis Wood
  • Liana Kurmanseitova
  • Ash Mukherjee
  • Samantha Sawyer
  • Carol Martire
  • Patricia Bermudez
  • Chacey Bennett
  • Meryl Simon
  • Wako Nicholas
  • Abubakre Tageldin
  • Mellisa Madsen

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