Basic ultrasound head-to-toe skills for intensivists in the general and neuro intensive care unit population: consensus and expert recommendations of the European Society of Intensive Care Medicine

Overview

This consensus from the European Society of Intensive Care Medicine sets out the basic point-of-care ultrasound skills that every intensivist should have. It covers patients in general intensive care units and in neurocritical care. The recommendations came from a structured expert consensus process, and they describe a head-to-toe approach in which ultrasound extends the bedside clinical examination.

Key skill areas

In the heart, the core skills are recognising gross abnormalities of left and right ventricular function, detecting pericardial effusion and supporting haemodynamic assessment. In the lungs, they include identifying pneumothorax, pleural effusion, consolidation and interstitial syndrome. In the abdomen, they include detecting free fluid, urinary retention and hydronephrosis. In the vessels, they include screening for deep venous thrombosis and guiding vascular access.

For neurocritical care, the consensus names basic skills in assessing the optic nerve sheath and in brain ultrasound, including transcranial Doppler. These can support the non-invasive evaluation of patients with acute brain injury.

Implications for training and practice

The document gives a reference framework for training curricula and competency assessment in critical care ultrasound. It stresses that findings must be interpreted in clinical context, that the technique depends on the operator, and that learners need supervised practice. It also marks where advanced skills and specialist imaging remain necessary. For ICUs, the practical value is a shared minimum standard, so that ultrasound is used consistently for diagnosis, monitoring and procedural guidance.