Hand-carried Ultrasound Performed by Hospitalists: Does It Improve the Cardiac Physical Examination?

Point-of-Care Echocardiography in the Accountable Care Organization Era

“…6 Several other studies have demonstrated improved diagnostic accuracy of POC echocardiography over the physical examination, echocardiography, chest radiography, and biomarkers in patients with cardiovascular disease that would lead to earlier identification and correct diagnosis of pathologies. 6,29,30 Similarly, in a study of 238 In another study of 49 patients with penetrating chest injuries, the survival was 100% in the group that underwent immediate POC echocardiography versus 57.1% in the group that did not. 32 The average time to diagnosis and disposition for surgical intervention was 15.5 minutes for the POC echocardiography group and 42.4 minutes for the non-echo group.…”

“…Potential solutions include traditional continuing medical education ultrasound courses or blended learning courses, which include web-based didactics followed by hands-on training. 30,49 Didactic training duration for POC echocardiography reported in the literature ranged from 2 to 30 hours, including review of normal and pathological studies, with subsequent performance of proctored examinations. 46,50 Depending on the extent of training and imaging goals, focused training resulted in moderate to excellent test accuracy (Table 3).…”

The future of pediatric US

“…These compact machines have captured the attention of nonradiology physicians increasingly performing point-of-care US in nontraditional settings. The development of new applications (especially in procedural guidance), and the expansion into underserved regions because of diminished costs have also fueled the expansion of this market [13][14][15]. These new users are attracted to the speed, flexibility, sufficient (and often excellent) image quality, and lower costs of purchase and maintenance of these compact systems.…”

“…In the United States, the Institute of Medicine and the Agency for Healthcare Quality and Research listed the implementation of USguided central venous access over traditional blind access as one of the top 10 changes that could most improve patient care [20]. In other scenarios, point-of-care US with very focused problem-oriented examinations is being shown to expedite diagnostic evaluations and interventional procedures and to improve patient care [13,15,21]. Ignoring for a moment the issues of money, politics, egos, resource duplication and utilization, performance quality and documentation, it is hard not to be in favor of the spread of US out of the hands of the traditional imaging experts for certain indications.…”

Pocket-sized Ultrasound for Physical Diagnosis

“…This choice is puzzling, since clinicians with limited training in point-of-care ultrasound have previously been shown to detect left ventricular systolic dysfunction and pericardial effusions, but not valvular heart disease. 4 Of the 17 physical exam abnormalities listed in Table 1, only three were abdominal pathologies (hepatomegaly, splenomegaly, and ascites). 1 The authors stratified their data by "organ system," but did not provide results for each specific abnormality.…”