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Letter to the Editor
Reply
Respuesta
Luis Castilla-Guerraa,b,
Corresponding author
castillafernandez@hotmail.com

Corresponding author.
, Antonio Gómez-Escobarc, Ernesto Carmona-Gonzálezd
a Servicio de Medicina Interna, Hospital Universitario Virgen Macarena, Sevilla, Spain
b Universidad de Sevilla, Sevilla, Spain
c Servicio de Oftalmología, Hospital Universitario Virgen Macarena, Sevilla, Spain
d Servicio de Radiología, Hospital de la Merced, Osuna, Sevilla, Spain
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    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">We thank Dr&#46; Callejas et al&#46; for their interest in our work and their valuable comments&#46;<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">Indeed&#44; there are multiple non-traumatic eyer emergencies in which point-of-care ultrasound is of inestimable value&#46; Thus&#44; for example&#44; in acute vascular pathology of the eye&#44; it is not only useful for assessing central retinal artery occlusion&#44; as mentioned in the article&#44; but also for assessing central retinal vein occlusion&#44; anterior ischaemic optic neuritis&#44; diabetic retinopathy or ocular ischaemic syndrome&#44; among others&#46;<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">However&#44; point-of-care ultrasound or POCUS in emergency medicine should be rapid&#44; focused&#44; and performed for a specific condition for which it has been shown to be useful&#46; In addition&#44; it should be easy to learn and only endeavour to demonstrate a few easily recognisable bedside findings&#46;<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> Therefore&#44; in our work we have focused on the most important pathologies that are easy to diagnose with basic ultrasound skills&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">In fact&#44; the <span class="elsevierStyleItalic">Accreditation Council for Graduate Medical Education</span> &#40;ACGME&#41; and the <span class="elsevierStyleItalic">American Board of Emergency Medicine</span> &#40;ABEM&#41;<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> describe 5 levels of skills in emergency ultrasound&#44; from medical student level 1 to level 5&#44; which includes skills in the use of advanced echocardiography or transcranial Doppler&#44; among others&#46; Also&#44; the <span class="elsevierStyleItalic">Royal College of Emergency Medicine</span> &#40;RCEM&#41;<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a> discusses various levels of skills&#44; pointing out 4 basic point-of-care ultrasound applications&#44; called CORE &#40;formerly level 1&#41; &#40;including the FAST protocol or the assessment of abdominal aneurysm&#41;&#44; which every physician must know in order to qualify as an emergency doctor&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">Similarly&#44; as we discussed in the article&#44; there are already proposals for basic ultrasound protocols&#44; such as the so-called ViGMO protocol&#44; for patients with acute vision-threatening non-traumatic ocular pathologies&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">Thus&#44; although there are many ocular diseases of great interest in point-of-care ultrasound&#44; we think it is more practical to know how to diagnose a common and serious pathology such as retinal detachment &#40;in which emergency point-of-care ultrasound has a sensitivity of 96&#46;9&#37; and a specificity of 88&#46;1&#37;<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a>&#41; than a carotid-cavernous fistula&#44; due to its rarity and diagnostic difficulties&#46;</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Conflict of interests</span><p id="par0035" class="elsevierStylePara elsevierViewall">None&#46;</p></span></span>"
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