Point-of-care ultrasound (POCUS) is rapidly becoming an essential tool in emergency medicine. Portable, safe, and capable of producing real-time images, POCUS helps clinicians make faster, more informed decisions—sometimes in life-or-death situations. We spoke with Samuel Beger, M.D., M.P.H., an emergency medicine physician at The University of Texas Health Science Center at Houston, about how POCUS is transforming patient care, guiding critical procedures, and advancing medical care in space.
How has ultrasound become part of emergency medicine training?
Dr. Beger: Ultrasound is now a core component of emergency medicine training. Many academic emergency medicine residencies have fellowships dedicated to ultrasound, and some faculty members specialize in the field, conducting research in emergency medicine. Technology keeps improving, making ultrasound an increasingly valuable tool in the emergency department.
How often do you use ultrasound in the emergency department?
Dr. Beger: I use it every day. When a patient comes in, I often tell my residents, “Get the ultrasound machine.” If a patient arrives with shortness of breath and a history of congestive heart failure or COPD, it can be difficult to determine the cause. POCUS allows you to quickly see whether the lungs are filled with fluid or whether the issue is more likely an exacerbation of COPD. The answer directly informs treatment decisions.
Does the use of ultrasound vary across different types of hospitals?
Dr. Beger: Yes. Academic programs tend to use it more, while busy community hospitals may use it less often. Part of this is that not every physician who trained a decade or more ago received extensive ultrasound training. Sometimes, even if the machines are available, physicians may not feel comfortable interpreting the images and may be less inclined to use the technology.
How do you use POCUS on a daily basis?
Dr. Beger: POCUS is a great tool for expediting time-sensitive care. In emergency medicine, we usually use ultrasound to answer specific questions quickly, not to perform detailed measurements as a cardiologist would. I might assess heart function more broadly—normal, moderately reduced, or severely reduced—rather than calculating precise ejection fractions.
For instance, if I suspect an aortic dissection—a tear in the wall of the body’s main artery—I can often identify it at the bedside. That allows immediate blood pressure management and early involvement of vascular surgery, potentially saving the patient’s life.
Do clinicians use POCUS to help guide certain medical procedures?
Dr. Beger: Ultrasound is essential for guiding procedures such as placing central lines or difficult IVs. Twenty years ago, most of these procedures were done blindly. Now, in our residency program, it is standard to use ultrasound guidance, which improves safety and success rates.
Can you tell us about your work with ultrasound in space medicine?
Dr. Beger: Ultrasound technology is incredibly futuristic and has broad potential not only on Earth but also in space. Because it is portable, safe, and radiation-free, ultrasound is used on the International Space Station. I am involved in training astronauts and collaborating with commercial space companies and NASA to develop procedures for using point-of-care ultrasound in space.
Is POCUS intended to replace traditional ultrasound?
Dr. Beger: No, not at all. POCUS is operator-dependent and designed for specific, rapid assessments. While I am not as proficient as a radiologist performing comprehensive diagnostic ultrasounds, POCUS allows me to make faster decisions and determine what further imaging is necessary.
What role is AI playing in ultrasound?
Dr. Beger: AI is starting to assist with POCUS. For example, some systems can automatically label organs during a FAST (Focused Assessment with Sonography for Trauma) exam or help calculate metrics like ejection fraction. While this is not mainstream yet, I expect AI to become widely used in the next five years, potentially improving the speed and accuracy of clinical decision-making. Still, proper training remains essential.
What happens if training or image quality is insufficient?
Dr. Beger: If you cannot interpret the images correctly, you might miss important clinical information. Emergency medicine training provides a solid core set of ultrasound skills, but practice and familiarity with high-quality machines are essential for maintaining competence. Newer machines generally provide clearer images, which helps with interpretation.
Any final thoughts or takeaways?
Dr. Beger: POCUS is an exciting, evolving field. It is low-risk for patients, highly portable, and increasingly integrated into emergency medicine. With better technology, AI, and continued training, POCUS will only become more useful. I am especially excited about the potential to expand its applications both on Earth and in space.