Current Practices and Gaps in Integrating Point-of-Care Ultrasound in Neonatal and Pediatric Transport: A Scoping Review

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Abstract
Background: Point-of-care ultrasound (POCUS) has emerged as a valuable tool for rapid diagnosis, procedural guidance, and real-time clinical decision-making in neonatal and pediatric critical care. Despite its growing use in acute medicine, the evidence describing its implementation, utility, and impact in interfacility and prehospital transport settings remains limited. This scoping review aims to systematically map the current body of evidence on POCUS use during neonatal and pediatric transport and to identify knowledge gaps to inform future research, training, and clinical integration. Methods: A scoping review was conducted following PRISMA-ScR 2020 guidelines, searching PubMed, Embase, Scopus, CINAHL, and Web of Science for studies describing POCUS use during neonatal and pediatric transport. Results: Of 3676 unique articles identified, 20 met inclusion criteria, including 10 cohort studies, 3 case series, 4 case reports, 2 narrative reviews, and 1 textbook chapter. Fifteen studies reported extractable patient-level data and were included in quantitative synthesis, encompassing 4278 patients. Among these, 1153 (27.0%) patients were under 18 years old, and 576 (13.5%) had POCUS performed during transport. POCUS was primarily used for diagnostic assessment—mainly lung and cardiac imaging—with variability in protocols, operator training, and transport characteristics. Eleven studies (73.3%) reported that POCUS altered clinical management, influencing management in 106 (18.4%) patients through diagnostic clarification, resuscitation decisions, medical or ventilator adjustments, and changes in transport destination. Conclusions: Evidence suggests that POCUS supports clinical decision-making and timely intervention during neonatal and pediatric transport, though use remains inconsistent. Future studies should focus on developing structured training frameworks, validating transport-specific protocols, and assessing the impact of POCUS on clinical outcomes and transport safety.

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