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Editor’s note: TSG has created a new on-line course with a spotlight on Point of Care Ultrasound (POCUS). Emergency physicians and other specialties embracing this technology should be aware of important current issues related to POCUS. What follows is a summary and case example from the course.  

POCUS: Evolving Standards of Care

Point-of-care ultrasound (POCUS) is rapidly transforming clinical practice by bringing real-time diagnostic imaging to the bedside. Once considered a niche tool in emergency departments, it is now used across multiple specialties to improve diagnostic accuracy, guide procedures, and accelerate clinical decision-making. From central line placement to the evaluation of trauma and abdominal aortic aneurysm (AAA), POCUS is helping clinicians make faster, safer, and more informed decisions that enhance patient outcomes.

As POCUS becomes more ingrained in clinical workflows, expectations around its use are increasing. Not using POCUS when clinically indicated has emerged as a leading cause of POCUS related malpractice claims. The legal landscape is shifting: clinicians are no longer being sued solely for misusing the technology, but for failing to use it altogether. To meet the evolving standard of care, healthcare organizations must ensure robust systems are in place for training, credentialing, documentation, and ongoing quality assurance.

Case Review

A 45-year-old man who presented to the emergency department with severe abdominal pain. The physician performed a POCUS exam to rule out an AAA but misread the scan and failed to document the findings or save images. The patient was discharged with a diagnosis of kidney stones and returned two days later in critical condition due to a ruptured AAA. He suffered permanent complications despite emergency surgery. A lawsuit followed, alleging that the physician had misread the scan—critically, he had not undergone any POCUS quality reviews since residency and had received no further instruction or credentialing in its use. The hospital was also implicated for failing to enforce quality oversight, revealing systemic vulnerabilities in risk management and patient safety protocols.

Beyond clinical utility, POCUS represents a powerful risk management and safety tool. When supported by structured education, credentialing, and QA programs, it reduces diagnostic errors, shortens time to treatment, and lowers procedural risks. Institutions that invest in proper implementation and oversight not only improve patient care but also protect themselves and their providers from preventable litigation.