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Expanding POCUS in Neurocritical Care through Educational Initiatives

By Currents Editor posted 06-28-2021 06:59


Bryan Boling, DNP, University of Kentucky

Jennifer Mears, PA, Weill Cornell Medicine/New York-Presbyterian Hospital

Aarti Sarwal, MD, Wake Forest Baptist Health

Judy Ch’ang, MD, Weill Cornell Medicine/New York-Presbyterian Hospital

Point-of-care-ultrasound (POCUS) is an indispensable tool used in the diagnosis, screening, procedural guidance, and management of critically ill patients across the world. Unlike other imaging modalities, POCUS is performed and interpreted by the intensivist at the bedside, enabling real-time management decisions while being cost-effective and safe. Literature increasingly supports POCUS use in intensive care, necessitating its use as a neurocritical care skill.  

Bedside cardiac ultrasound, lung ultrasound, and POCUS-guided assessment of shock are some of the specific applications that benefit neurocritical care providers. Additionally, transcranial doppler imaging is frequently used to screen for potential cerebral vasospasm in patients with subarachnoid hemorrhage or for ICP assessment. Optic nerve sheath diameters can be measured to monitor intracranial pressure if an invasive ICP monitor cannot be placed and midline shift and hydrocephalus can be detected through cranial POCUS. 

Despite its value, POCUS use among neurointensivists is highly variable. Dr. Aarti Sarwal led an initiative to create the Ultrasound Section of the Neurocritical Care Society to provide access to resources, educate the NCC community, foster research collaboration, and engage all providers with a shared interest in ultrasound.

The NCS Ultrasound Section is creating a POCUS Webinar Series and recurring case studies in Currents to increase education and involvement of the neurocritical care community. Every month beginning in 2022, we will offer webinars by qualified POCUS users who will explore different topics that range from how to perform and interpret different ultrasound exams to building a POCUS program in your neurological ICU. The recurring ultrasound case studies published here in Currents will showcase how NCC providers are currently using ultrasound in the diagnosis, screening, and management of our patients. The goal of these educational initiatives is to engage and excite the neurocritical care community by creating a foundation of knowledge of important ultrasound techniques and their applications. 

For providers of all ultrasound-competency levels, we hope through these education initiatives to empower you to use POCUS to improve patient care. 

Please join us at our next section meeting and webinar! Cases and ideas can be submitted to If you are interested in being a speaker at a webinar – please fill out this survey or email



Lauren Koffman, DO, MS As a member of the Educational Products Committee, one of many committees within the Neurocritical Care Society, I was recently asked to review A Guide to Traumatic Brain Injury: The Intensive Care Unit . This guide was written several years ago by Dr. David Y. Hwang and ...
Jenna Gonillo Davis, MS, ACNPC-AG, CCRN Angie Murkins, FNP-BC Ana Kukulj, FNP-C, MSN, BSN, RN Advanced practice providers (APPs) have become the ever-present providers in critical care departments. They act as a stabilizing force for intensive care units (ICU) where residents and ...
Gantner D, Wiegers E, Bragge P, Finfer S, Delaney A, van Essen T, Peul W, Maas AIR, Cooper DJ. Decompressive Craniectomy Practice following Traumatic Brain Injury in Comparison with Randomized Trials: Harmonized, Multi-Center Cohort Studies in Europe, the United Kingdom, and Australia. J Neurotrauma. ...