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Background Adding point-of-care ultrasound to the physical examination of patients to assess early signs of decompensation and fluid overload has been proven to add information and improve quality of care, also when performed by nurses. Few studies have examined intensive care nurses’ point-of-care ultrasound examinations in acute cardiac settings. Purpose  To evaluate if the findings of intensive care nurses ultrasound examinations, after brief training, were in agreement with conventional ultrasound examination performed by physicians. Methods  This comparative cross sectional interrater agreement study included 50 patients admitted with signs and symptoms of dyspnoea and suspected cardiac disease to a cardiac intensive care unit. After brief training, the study nurses performed standardized examinations of the patients’ inferior vena cava (IVC) and the pleural- and pericardial cavities using a handheld ultrasound device. A physician repeated the same examinations using conventional ultrasound, blinded of the nurses’ findings. Results Analysis using Gwets agreement coefficient (AC2) with quadratic weights showed moderate agreement for the IVC respiration variation 0.60 (95% CI 0.38-0.82), and substantial agreement for the IVC diameter 0.70 (95% CI 0.50- 0.90) and right-sided pleural effusion 0.70 (95% CI 0.52-0.88). For left-sided pleural effusion 0.85 (95% CI 0.75-0.95) and for pericardial effusion 0.95 (95% CI 0.90-1.01) the agreement was almost perfect.  Conclusion This study indicates that intensive care nurses, after brief training in point-of- care ultrasound, can perform reliable examinations of the IVC and pleural- and pericardial cavities compared to a physicians conventional ultrasound examination.

Handheld ultrasound; point-of-care examinations by intensive care nurses in a cardiac intensive care unit. An interrater agreement study