Point-of-Care Ultrasound in Paediatric Emergency Resuscitation: A Narrative Review

Abstract

Point-of-care ultrasound (POCUS) has progressively established itself as an indispensable diagnostic and procedural adjunct in paediatric emergency medicine, transforming the capacity of clinicians to assess and manage critically ill children at the bedside. Unlike its adoption in adult emergency medicine, the integration of POCUS into paediatric emergency resuscitation has followed a somewhat more uneven trajectory, shaped by anatomical peculiarities unique to the developing body, institutional variation in training provision, and a relative scarcity of large-scale paediatric-specific evidence. This critical narrative review synthesises the available evidence across the primary resuscitation domains of POCUS application in paediatric emergency care: cardiac arrest and rhythm assessment; haemodynamic evaluation and undifferentiated shock; airway management; pulmonary and thoracic imaging; focused cardiac ultrasound; procedural guidance including vascular access and lumbar puncture; and targeted abdominal diagnosis. A structured narrative review was conducted using PubMed/MEDLINE, Scopus, Web of Science, Google Scholar, Embase, and the Cochrane Library, with literature searches covering the period from January 2001 to the present. The review critically appraises the diagnostic accuracy, procedural benefits, and clinical impact of POCUS across these domains, drawing on systematic reviews, meta-analyses, and landmark observational and interventional studies. It also examines current frameworks for training, credentialing, and quality assurance, alongside the significant barriers — particularly those related to operator dependency, training heterogeneity, and resource constraints — that continue to limit uniform implementation. The article identifies areas where evidence is emerging and highlights directions for future research, including simulation-based learning, artificial intelligence-assisted imaging, and the expanding role of POCUS in neonatal resuscitation and low-resource settings. The overall picture that emerges is of a technology with compelling and, in many domains, well-evidenced clinical utility, but one whose full potential in paediatric emergency resuscitation remains contingent on structured training systems, standardised protocols, and ongoing high-quality research.