Background: The integration of Point of Care Ultrasound (POCUS) in clinical settings has been progressively recognized for its potential in improving patient outcomes. Our study introduces the Admission POCUS Examination (Apex) protocol, a comprehensive POCUS-based approach designed to optimize patient care at the point of admission in hospital medicine wards.

Methods: This retrospective study involved 134 patients admitted to a hospital medicine ward from November 1, 2021, to May 31, 2022. Participants underwent the Apex protocol, which entails a full-body POCUS evaluation upon admission. Data collected included demographics, average hospital stay, Apache II scores, Charlson Comorbidity Index (CCI), and subsequent prescription adjustments based on the Apex findings.

Results: The average age of participants was 73 ± 14 years, with a slight female predominance (51%). The mean hospital stay was 22 ± 18 days, average APACHE II score was 14 ± 6, and the CCI averaged at 6 ± 3. After adjusting for APACHE II and CCI, the Inferior Vena Cava (IVC) assessment in Apex emerged as an independent predictor for adjusting admission prescriptions. This finding underlines the critical role of IVC evaluation in refining patient management strategies at the point of entry.

Conclusions: The Apex protocol, with a special emphasis on IVC assessment, plays a pivotal role in tailoring patient care right from admission, indicating a paradigm shift in hospital medicine. Its implementation could lead to more personalized and effective treatment strategies, potentially reducing hospital stay and improving patient outcomes. This study marks a significant step towards enhancing the precision and impact of POCUS in the clinical setting.