POCUS: another wee paper from GN et al.

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Rural point-of-care ultrasound of the kidney and bladder: quality and effect on patient management

Nixon Garry, Blattner Katharina, Muirhead Jill, Kerse Ngaire (2018) Rural point-of-care ultrasound of the kidney and bladder: quality and effect on patient management. Journal of Primary Health Care , -.

Open access.


POCUS really is a incredible tool that makes a large difference to clinicians and patients. No suprise here to see bladder and kidney scans having high sens and spec for urinary retention and hydronephrosis amongst rural hospital doctors. There needs to be a national credentialling service for rural clinicians to tap into.


INTRODUCTION: Point-of-care ultrasound (POCUS) of the kidney and bladder are among the most commonly performed POCUS scans in rural New Zealand (NZ).AIM: To determine the quality, safety and effect on patient care of POCUS of the kidney and bladder in rural NZ.METHODS: Overall, 28 doctors in six NZ rural hospitals completed a questionnaire both before and after undertaking a POCUS scan over a 9-month period. The clinical records and saved ultrasound images were reviewed by a specialist panel.

RESULTS: The 28 participating doctors undertook 138 kidney and 60 bladder scans during the study. POCUS of the bladder as a test for urinary retention had a sensitivity of 100% (95% CI 88–100) and specificity of 100% (95% CI 93–100). POCUS of the kidney as a test for hydronephrosis had a sensitivity 90% (95% CI 74–96) and specificity of 96% (95% CI 89–98). The accuracy of other findings such as renal stones and bladder clot was lower. POCUS of the bladder appeared to have made a positive contribution to patient care in 92% of cases without evidence of harm. POCUS of the kidney benefited 93% of cases, although in three cases (2%), it may have had a negative effect on patient care.

DISCUSSION: POCUS as a test for urinary retention and hydronephrosis in the hands of rural doctors was technically straightforward, improved diagnostic certainty, increased discharges and overall had a positive effect on patient care.

excuse the pun...

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