The Aorta Ultrasound (POCUS)
Overview
Point‑of‑care ultrasound (POCUS) of the abdominal aorta is a rapid bedside test to detect abdominal aortic aneurysm (AAA), suggest rupture or contained leak, and contribute to assessment of undifferentiated shock. UK guidance supports immediate bedside aortic ultrasound when ruptured AAA is suspected (NICE NG156).
Use POCUS to answer focused clinical questions quickly, document clearly, and escalate without delay when required.
Indications
- Suspected ruptured or symptomatic AAA, for example acute abdominal or back pain with hypotension, syncope, or collapse; perform immediate bedside scan if suspected (NICE NG156).
- Undifferentiated shock or collapse as part of focused shock protocols (for example, RUSH).
- Rapid assessment of a known AAA when immediate management decisions are required, performed in conjunction with vascular advice.
- Directed peri‑arrest assessment, performed only by trained operators and without prolonging chest compressions.
Anatomy for scanning
The Thoracic Aorta
- The Ascending Aorta: Begins at the sternal angle and extends up to T4/T5, just before the aortic arch.
- Aortic Arch: The curve starting at T4/T5, reaching down to T3, ending at T4, and having three main branches: The Brachiocephalic artery, The Left common carotid artery and The Left subclavian artery.