AUTHOR=Ienghong Kamonwon , Apiratwarakul Korakot , Khemtong Sukanya , Cheung Lap Woon 

TITLE=Applications and indications of point-of-care ultrasound in emergency department encounters involving palliative care patients

JOURNAL=Frontiers in Medicine

VOLUME=Volume 12 - 2025

YEAR=2025

URL=https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2025.1719679

DOI=10.3389/fmed.2025.1719679

ISSN=2296-858X

ABSTRACT=BackgroundPoint-of-care ultrasound (POCUS) is a rapid bedside imaging technique that facilitates symptom-focused, targeted care for palliative patients presenting to the emergency department (ED). This study outlines the indications, ultrasound-detected diagnoses, and procedural applications of POCUS in palliative care patients at a tertiary ED in Thailand.MethodsA retrospective analysis of adult emergency department encounters at Srinagarind Hospital was conducted from January 2020 to December 2024. Patients aged 18 years or older, classified under ICD-10 Z51.5 (palliative care), with documented POCUS examinations in the electronic medical record were included. Demographic data, presenting complaints, triage levels, the purpose of POCUS (diagnostic, procedural guidance, or both), and POCUS findings as recorded by the performing emergency medicine team were collected. Descriptive statistics were used to summarize the findings.ResultsOf 875 emergency department patients classified as palliative, 434 (49.6%) had documented point-of-care ultrasound (POCUS) and were included in the study. The median age was 71 years (range 64–97). Of these, 59.7% were male, and 74.9% had oncological diagnoses. High-acuity triage levels (1–2) accounted for 41.9% of cases. POCUS was primarily used for diagnostic assessment in 74.9% of cases and for procedural support in 42.2% of patients. The most frequently identified conditions were ascites (42.6%) and pleural effusion (11.1%). The most common POCUS-guided procedures were abdominal paracentesis (34.8%) and thoracentesis (7.4%).ConclusionPOCUS frequently addressed symptom-directed concerns in palliative patients in the emergency department, commonly identifying fluid-related causes of distress and enabling bedside, symptom-relieving procedures. With appropriate training, governance, and prospective evaluation of patient-centered outcomes, POCUS has the potential to enhance acute supportive care for palliative patients across Thailand.