Point-of-Care Ultrasound in Resource-Limited Settings: Common Applications

Point-of-care ultrasound (POCUS) is used increasingly in resource-limited settings (RLSs), particularly as inexpensive ultrasound machines and evidence-based protocols become more available. POCUS often is the only imaging modality available in such settings, and it has the potential to significantly affect patient care. This article discusses four case-based reviews of POCUS in RLSs for several common diseases: pediatric pneumonia;...

A Late-Career Internist and Point-of-Care-Ultrasound in a Primary Care Clinic

I (TKR) turn 70 this year and have been a clinician, teacher, researcher, and leader in an internal medicine program. My interest in the physical examination began in medical school and stimulated 25 years of teaching a physical diagnosis course...

Shaping the Future of Point-of-Care-Ultrasound in Medical Education

In the last 60 years, ultrasound (US) has developed into a critical imaging tool, with clinicians using this modality as part of the noninvasive approach to patient care with an ever-increasing...

Point-of-Care Ultrasound for Internal Medicine: An International Perspective

Point-of-care ultrasound (POCUS) is a rapidly evolving diagnostic modality and has been touted as the visual stethoscope of the 21st century. During the past decade, POCUS has emerged as a tool that can be used by internists as a POC extension of physical examinations and for providing high-quality clinical care at the...

Point-of-Care Ultrasound Needs Assessment, Curriculum Design, and Curriculum Assessment in a Large Academic Internal Medicine Residency Program

Objectives: Internal medicine (IM) residency point-of-care ultrasound (POCUS) curricula are being developed but often are limited in scope or components. In this article, we discuss the demonstration of a need for POCUS training in our large academic IM residency program; the development of a longitudinal curriculum; and the impact of the curriculum on POCUS knowledge, use, and confidence. Methods: In 2014, we designed a cross-sectional POCUS...

Point-of-Care Ultrasound as Part of a Short-Term Medical Mission to Rural Nicaragua

Objectives: The lack of access to diagnostic imaging in resource-limited settings (RLSs) poses a worldwide problem. Advances in ultrasound (US) imaging technology bridge this gap, particularly when examinations are performed by physicians and integrated into the patient encounter, termed point-of-care ultrasound (POCUS). Because the number of physicians participating in short-term medical missions (STMMs) is increasing, the authors sought to...

“Old Dogs” Can Learn Ultrasound

It is said that you cannot teach old dogs new tricks. For those of us who completed our internal medicine residency 15 to 20 years ago, point-of-care ultrasound (POCUS) is just that, a new trick. There are few articles about POCUS in the internal medicine literature before 2000. POCUS was not even used routinely for procedures such as central lines and paracentesis by internists until 10 to 15 years...

Point-of-Care Ultrasound in the Inpatient Setting: A Tale of Four Patients

Point of-care ultrasound (POCUS) has become a mainstream bedside tool for clinicians in several specialties and is gaining recognition in hospital medicine. There are many clinical applications in which the inpatient practitioner can use POCUS to improve his or her diagnosis, monitoring, and treatment of patients. POCUS is valuable in many clinical scenarios, including acute renal failure, increasing lower extremity edema, change in inpatient...

Point-of-Care Ultrasound Improves Shared Diagnostic Understanding Between Patients and Providers

Objectives: Point-of-care ultrasound (POCUS) has become an integral part of the physical examination. The effect on shared understanding of adding POCUS to the traditional examination is unknown, yet this is an often-described benefit of POCUS. The primary aim of this study was to determine whether the use of POCUS improves shared understanding between providers and patients about patients’ diagnoses. Methods: This was a prospective...

A Patient’s Perspective: Pairing the Stethoscope with POCUS to Evaluate Acute Dyspnea in the Clinic

Mr Hughes was a 55-year-old chaplain at our hospital, the father of three boys, and was one of my healthiest continuity patients. He had yearly physicals and lab work, ran 6 miles a day, and was the last person that I thought I would have to send to the emergency department (ED) for a life-threatening...

Point-of-Care Ultrasound: At the Crossroads of General Medicine

I am honored to introduce this special issue on point-of-care ultrasound (POCUS) for the Southern Medical Journal on behalf of a diverse group of physicians. This group is composed of academic and community physicians who practice in outpatient and hospital settings, representing multiple institutions from across the globe. Some learned POCUS early in their training, whereas some learned it much later, but all have expertise in a growing...

Point-of-Care Ultrasound Applications in the Outpatient Clinic

Although the use of point-of-care ultrasound (POCUS) is well established in the emergency department (ED) and intensive care unit, the use of POCUS in the outpatient clinic setting is still emerging. General practitioners and specialists alike have increasing access to smaller and less expensive US devices that can assist in making timely diagnoses, guiding procedures, and monitoring patients. In this case-based review, we highlight some of the...

Point-of-Care Sinus Ultrasound: Impact Within a Large Internal Medicine Clinic and Review of Technique

Outpatient diagnosis of acute bacterial sinusitis, using only traditional physical examination and clinical criteria, results in the overuse of antibiotics in patients with upper respiratory complaints. Point-of-care maxillary sinus ultrasound is easy to learn and quick to perform in a primary care clinic. The technique can reduce antibiotic prescribing by reassuring both patients and providers of the absence of fluid in the sinus, the hallmark...

Point-of-Care Ultrasound in Established Settings

The original and most widely accepted applications for point-of-care ultrasound (POCUS) are in the settings of trauma, shock, and bedside procedures. Trauma was the original setting for the introduction of POCUS and has been standardized under the four-plus view examination called the Focused Assessment with Sonography in Trauma (FAST). This examination was found to be especially practice changing for achieving rapid diagnoses in critically ill...

Introduction to Special Issue on Point-of-Care Ultrasound

The Southern Medical Journal is pleased to publish a special issue on point-of-care ultrasound as an introduction for the readers to the expanding utilization of this technology in the clinical setting. We appreciate Dr Michael Wagner’s stewardship of the special issue as Guest Editor, as well as the authors and reviewers who provided expertise for the specific assignments and applications of the...

PEARLS for an Ultrasound Physical and Its Routine Use as Part of the Clinical Examination

At present, there is no consensus on what a routine examination that uses ultrasound (US) should look like. Point-of-care US (POCUS) is poised to be as important a clinical skill as palpation and auscultation; however, the expansive list of potential applications can be intimidating to the beginner. In this article we propose using a PEARLS (Parasternal, Epigastric, Anterior Lung , Right upper quadrant, Left upper quadrant, and Suprapubic)...

Improving Medical Students’ Perceptions of Older Adults by Engaging Older Military Veterans in Recreational Activities

To the Editor: The aging of the US population has led to a shortage of physicians in geriatrics to care for the 30% of older adults who should be seen by a geriatrician.1 To compound this deficit, few physicians are choosing to specialize in this...

Brucellosis in Adults and Children: A 10-Year Case Series at Two Large Academic Hospitals in Houston, Texas

Objectives: Brucellosis is one of the most common zoonoses worldwide. Most cases in the United States occur among travelers or immigrants from endemic regions, mostly Central America. In this study, we aimed at describing and comparing the epidemiology and clinical presentation of brucellosis in pediatric and adult patients at two large tertiary care centers in Houston, Texas. Methods: We identified patients diagnosed as having brucellosis...

A Look Through Time: Historical Analysis of Obstetrics and Gynecology Texts Highlights Changes in Medicine

Objective: Our objective was to analyze systematically the preface and foreword of each edition of Williams Obstetrics and Te Linde’s Operative Gynecology to gain insight into historical changes in medicine. Methods: The preface and foreword from 24 editions of Williams Obstetrics and 11 editions of Te Linde’s Operative Gynecology were obtained. Documents were assessed for the inclusion of predefined key words or topics, including...

Public CPR and AED Knowledge: An Opportunity for Educational Outreach in South Carolina

Objectives: Sudden cardiac arrest (SCA) remains a significant cause of morbidity and mortality, and the key to increased survival is emergent bystander intervention. A growing body of evidence has shown that timely bystander-initiated cardiopulmonary resuscitation (CPR) and defibrillation are significantly correlated with an increased likelihood of survival. Despite these demonstrated benefits, bystanders perform these interventions in less than...