Modelo Point-of-Care Ultrasound en Atención Primaria: ¿herramienta de alta resolución?

Abstract

Point-of-Care Ultrasound is a method of performing a rapid clinical ultrasound, with the aim of responding to a clinical question immediately. This is not an ultrasound performed systematically as the radiologists do, nor does it pretend to replace it. It is useful in some kind of screening (abdominal aortic aneurysm) and is of special interest in ultrasound-guided procedures (joint infiltration by injection). It allows to adapt the derivations, minimising the uncertainty, ruling out certain pathologies due to its high diagnostic precision. It can also lead to overdiagnosis, if the examinations carried out are not limited to the organs on which our clinical suspicion is based. Ultrasound is one tool more in the diagnostic process, but its use must be limited to certain clinical situations. Its use in early detection of prevalent diseases in Primary Care should be properly evaluated. On the other hand with more evidence of a high diagnostic accuracy in a large list of pathological conditions.

Environmental and Patient Impact of Applying a Point-of-Care Ultrasound Model in Primary Care: Rural vs. Urban Centres

“…Ultrasound is an additional tool in the diagnosis process, but its use should be limited to certain clinical situations. Its use in the early detection of diseases prevalent in primary care ought to be appropriately evaluated [8].…”

“…Several studies have analysed the environmental impact of the provision by primary care centres (PCCs) of various healthcare services, which up until now have been provided by hospitals or specialized services [5,6], thus avoiding the patient's need to travel to a specialized service [6][7][8]. However, the potential impact of conducting ultrasound scans in PCCs with regard to pollutant emissions has not previously been studied.…”

“…The potential for non-radiologists to perform ultrasound scans, what is known as the point-of-care ultrasound (POCUS) model [8], means the technique can actually form part of the consultation, giving it great potential for a timely evaluation and a speedy diagnosis. This in turn makes it highly appealing to GPs, who have increasingly undergone the necessary training to provide this service.…”

Ecografía a pie de cama en atención primaria

“…El desarrollo del ultrasonido ha revolucionado la práctica médica, pues en un profesional entrenado incrementa precisión y la resolutividad con un método económico y reproducible, cada vez más accesible en los servicios de atención primaria 1 , 2 . Hasta hace unas décadas la ecografía fue considerada una prueba de imagen limitada al servicio de radiología y realizada por especialistas en imágenes diagnósticas; sin embargo, durante los últimos años el ultrasonido se ha venido trasladando a la cabecera de la cama del paciente e incorporando a la práctica clínica de numerosas especialidades, como es el caso de la medicina de urgencias y de la medicina familiar 2 , 3 , 4 .…”

“…La ecografía en atención primaria constituye una herramienta que optimiza la práctica clínica del profesional y genera en el paciente una sensación de ser más valorado 2 , 3 . Sin embargo, su beneficio continúa siendo una herramienta explorador-dependiente, por lo cual su aplicación debe estar condicionada por el cumplimiento de un plan de formación controlado y acreditado ofrecido por especialistas radiólogos y no radiólogos entrenados que aseguren un alto grado de concordancia durante su proceso de entrenamiento 7 , a pesar de no ser periodos formativos excesivamente largos 6 .…”