Bottom line:
- POCUS can be an effective tool for ruling out SBO in the emergency department given its high sensitivities and low negative likelihood ratios in patients with low suspicion for SBO
- POCUS can help speed up the time to diagnosis, disposition, and surgical consult for patients with SBO findings on u/s
- CT scan is still the gold standard for detecting SBO

Study 1: A Prospective, Multicenter Evaluation of Point-of-care Ultrasound for Small-bowel Obstruction in the Emergency Department
- sensitivity and specificity of US were 88% and 54%, respectively
- negative likelihood ratio and positive likelihood ratios of US were 0.22 and 1.92, respectively
- this study included residents, fellows, and attendings, which helps towards generalizability
- there was no standardization of US technique, which may make duplication of results more difficult

Study 2: Diagnostic Accuracy and Time-Saving Effects of Point-Of-Care Ultrasonography in Patients with Small Bowel Obstruction: A Prospective Study

- sensitivity and specificity of US were 87.5% and 75.3%, respectively

- negative predictive value and positive predictive value of US were 94.6 and 54.9, respectively

- mean and median time to preliminary results from CT order were 222 minutes (3 hours and 42 min) and 208 minutes, respectively

- mean and median time to preliminary results from US order were 11 minutes and 10 minutes, respectively

- this study included residents, fellows, and attendings, which helps towards generalizability

- they did include standardization approach to US, which may make duplication of results easier

References:

Becker BA, Lahham S, Gonzales MA, et al. A Prospective, Multicenter Evaluation of Point-of-care Ultrasound for Small-bowel Obstruction in the Emergency Department. Acad Emerg Med. 2019;26(8):921-930. doi:10.1111/acem.13713

Boniface KS, King JB, LeSaux MA, Haciski SC, Shokoohi H. Diagnostic Accuracy and Time-Saving Effects of Point-of-Care Ultrasonography in Patients With Small Bowel Obstruction: A Prospective Study. Ann Emerg Med. 2020;75(2):246-256. doi:10.1016/j.annemergmed.2019.05.031