Point-of-care ultrasound in pediatric emergency medicine: Narrative review on current applications, limitations, and future directions

Francesco Sogni; Simone Pilloni; Lorenzo Ciavola; Claudia Infantino; Cristiano Conte; Valentina Fainardi; Susanna Esposito

doi:10.23750/abm.2026.18209

Authors

Francesco Sogni Pediatric Clinic, Parma University Hospital, Department of Medicine and Surgery, University of Parma, Parma, Italy
Simone Pilloni Pediatric Clinic, Parma University Hospital, Department of Medicine and Surgery, University of Parma, Parma, Italy
Lorenzo Ciavola Pediatric Clinic, Parma University Hospital, Department of Medicine and Surgery, University of Parma, Parma, Italy
Claudia Infantino Pediatric Clinic, Parma University Hospital, Department of Medicine and Surgery, University of Parma, Parma, Italy
Cristiano Conte Pediatric Clinic, Parma University Hospital, Department of Medicine and Surgery, University of Parma, Parma, Italy
Valentina Fainardi Pediatric Clinic, Parma University Hospital, Department of Medicine and Surgery, University of Parma, Parma, Italy
Susanna Esposito Pediatric Clinic, Parma University Hospital, Department of Medicine and Surgery, University of Parma, Parma, Italy

Keywords:

point-of-care ultrasound; pediatric emergency medicine; e-FAST; resuscitation; procedural guidance; diagnostic imaging.

Abstract

Point-of-care ultrasound (POCUS) has emerged as an invaluable tool in pediatric emergency medicine, offering rapid, non-invasive, and radiation-free diagnostic and procedural support directly at the bedside. Its applications span three major domains: resuscitation, diagnostics, and procedures. In resuscitation, protocols such as e-FAST and RUSH facilitate rapid assessment of trauma, shock, and cardiac function, enabling timely intervention. Diagnostic uses encompass a broad spectrum, including soft tissue infections, pulmonary conditions, gastrointestinal emergencies, musculoskeletal injuries, renal pathology, testicular torsion, and ocular abnormalities. Procedurally, POCUS enhances accuracy and safety in endotracheal tube placement, vascular access, lumbar puncture, arthrocentesis, and suprapubic bladder aspiration. Evidence supports that POCUS can improve diagnostic accuracy, reduce time to intervention, and optimize patient management in pediatric emergency settings. However, its effectiveness and safety are dependent on rigorous, competency-based training programs that move beyond minimum scan numbers to include objective assessment and quality assurance, as highlighted in recent international guidelines. Limitations include operator dependence, potential misinterpretation, inability to visualize certain pathologies, and variability in integration into clinical workflows. Future research should focus on standardizing pediatric-specific protocols, defining competency thresholds, and evaluating the cost-effectiveness and patient-centered outcomes of POCUS implementation. Multicenter trials are needed to validate its role in diagnostic algorithms, assess its impact on patient flow, and explore novel applications such as artificial intelligence-assisted interpretation. Given its versatility and growing evidence base, POCUS represents a critical adjunct in pediatric emergency medicine, with the potential to reshape diagnostic and procedural strategies while improving safety and efficiency in acute care.

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