Using Point-of-care Testing in Emergency Department and Its Impact on Length of Stay in Emergency Department

Point of care ultrasound (POCUS) was initially utilized by clinicians in the 1960s; however, its use has gained significant traction into routine practice enables emergency clinicians to make quicker clinical decisions and initiate the timely treatments in emergency room. This review aims to address the question of whether POCUS contributes to a reduction in length of stay (LOS) within emergency departments. The Preferred Reporting Items for Systematic Reviews and Meta Analyses guidelines and we included randomized controlled trials, prospective and retrospective observational studies which reported the length of the stay in emergency room. The details retrieved included study authors, year of publication, country, study type, study participants, sample size, age, gender, inclusion criteria, exclusion criteria, indications for point of care testing, type of point of care testing, outcomes, follow up, and any other relevant details. The search yielded a total of 564 articles. Full texts of 59 studies were reviewed, of which 41 were excluded with reasons provided and 18 were included in the results synthesis. POCUS was used for a range of conditions, and the majority of the studies suggested improvements in both time to reduction and overall, LOS in the emergency room (ER) with the use of the “POCUS in ER” strategy. Although there is evidence that POCUS is a valuable tool for improving ED efficiency, reducing LOS, and maintaining diagnostic accuracy across a range of conditions, further studies are needed to explore its effectiveness, including the impact of operator skill, proper integration into workflows, and protocols for follow up imaging indications and timings.