Focused cardiac ultrasound. must- or nice-to-have?

The timely diagnostic evaluation of critically ill patients presenting to the emergency department or the intensive care unit is mandatory for further management of affected patients (golden hour of shock). In addition to a physical examination, rapid focused cardiac ultrasound (FoCUS) is increasingly used to evaluate cardiac function and pathologies. FoCUS is recommended as a bedside diagnostic tool by international societies in the evaluation and prompt management of patients in shock. A wide range of emergency and critical care specialists should be able to perform this evidence-based cardiac ultrasound technique. The use of FoCUS can be learned relatively easily by expert-guided and subsequent training under supervision. Of note, the accuracy of diagnosing a limited number of critical cardiac pathologies by FoCUS is high even for noncardiologists. However, inherent limitations of FoCUS have to be appreciated. Thus, FoCUS is a aEuromust-have" to evaluate the critically ill patient in shock but cannot replace expert-guided comprehensive echocardiography.