In the whirlwind of emergency veterinary medicine, it sometimes feels like we’re expected to conjure answers out of thin air. Patients arrive collapsed, gasping, or pale, and we have only moments to act. While we may not have a spellbook or cauldron, we do have a tool that often feels a little magical: point-of-care ultrasound (POCUS). Here at Mountainside Animal Emergency and Specialty, every patient that presents for an emergency visit receives a POCUS as part of our standard of care.

From Bulky Machines to Everyday Magic

Ultrasound equipment was once the stuff of legend due to being so bulky and expensive. Fortunately, modern portable units are smaller, more affordable, and user-friendly. Today’s machines fit easily into emergency practice workflows, ensuring our clinicians can perform POCUS on every emergency patient who comes through the door, improving overall patient care.

A Modern Standard of Care

Adopting POCUS isn’t about replacing comprehensive imaging; it’s about embracing a modern, minimally invasive standard that enhances our emergency toolkit. In human medicine, POCUS is considered essential, and research shows it improves outcomes and reduces unnecessary testing.^1,2 Veterinary medicine is catching up quickly, and every time we wield this tool, we move closer to making it a true standard of care.

Speed, Structure, and Clarity

POCUS also saves time. One of our trained professionals can complete a POCUS in under five minutes. That speed makes it invaluable not only for stabilizing patients but also for guiding client conversations. When we perform a POCUS exam, we use a structured approach called the ‘four-quadrant scan.’ This involves placing the ultrasound probe on four key areas of the abdomen to quickly look for any hidden fluid or abnormalities. By moving methodically through each quadrant, we can detect problems like internal bleeding or fluid build-up within minutes, giving us vital information to guide immediate treatment.

Seeing Is Believing

Showing a worried owner a black pocket of free fluid or the “swinging heart” of tamponade brings clarity faster than any spooky medical jargon. Instead of feeling lost in a haunted house of medical uncertainty, clients can see what we see and make more confident, timely choices for their pets.

Where POCUS Shines Brightest

Emergency consults are where this tool shines brightest. A focused abdominal scan can reveal the shadowy presence of free fluid in trauma patients, pointing us toward hemoabdomen. Thoracic POCUS may uncover pericardial effusion before a patient crashes or show the ghostly shimmer of pleural fluid contributing to respiratory distress. Even a collapsed patient becomes less of a mystery once you know whether ascites, pericardial effusion, or pulmonary edema are in play. In each of these cases, POCUS transforms the unknown into the known, stripping away the “fog of war” that so often haunts emergency medicine.

Focused Questions, Powerful Answers

Unlike full diagnostic ultrasonography, POCUS isn’t meant to reveal every secret lurking inside a patient. Instead, it answers focused, binary questions: Is there free fluid? Is the heart surrounded by an ominous effusion? Are the lungs wet, dry, or “bewitched” by pathology? By providing immediate, actionable information at the patient’s side, POCUS lets us cut through uncertainty and act decisively without the help of a crystal ball.

Not Hocus Pocus—Just Good Medicine

As Halloween approaches, remember that not all magic requires a wand. Sometimes it just takes an ultrasound probe, a trained eye, and the right set of questions. POCUS isn’t hocus pocus; it’s evidence-based, lifesaving, and a vital part of our emergency arsenal. In emergency medicine, the scariest thing of all is uncertainty. With POCUS as part of our emergency services, we can take the guesswork out of critical situations and focus on what matters most: giving each pet the best chance at recovery.

1. Smallwood N, Dachsel M. Point-of-care ultrasound (POCUS): unnecessary gadgetry or evidence-based medicine? Clin Med (Lond). 2018 Jun;18(3):219-224. doi: 10.7861/clinmedicine.18-3-219. PMID: 29858431; PMCID: PMC6334078.

2. Fraleigh CDM, Duff E. Point-of-care ultrasound: An emerging clinical tool to enhance physical assessment. Nurse Pract. 2022 Aug 1;47(8):14-20. doi: 10.1097/01.NPR.0000841944.00536.b2. PMID: 35877142; PMCID: PMC9301985.