July 2018, Volume 111 - Issue 7

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

Michael Wagner, MD, Janice Boughton, MD

Abstract: 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...

(pp 389-394)

Introduction to Special Issue on Point-of-Care Ultrasound

G. Richard Holt, MD, MSE, MPH, MABE, DBioethics

Abstract: 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...

(pp 371)

Point-of-Care Ultrasound in Established Settings

Dustin Morrow, MD, Julia Cupp, MD, David Schrift, MD, Robert Nathanson, MD, Nilam J. Soni, MD, MSc

Abstract: 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...

(pp 373-381)

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

David M. Tierney, MD, Joshua S. Becker, MD, Bryan D. Post, MD, Terry K. Rosborough, MD

Abstract: 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...

(pp 411-417)

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

Michael Wagner, MD

Abstract: 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,...

(pp 372)

Point-of-Care Ultrasound Applications in the Outpatient Clinic

Michael Wagner, MD, Joy Shen-Wagner, MD, Kang X. Zhang, MD, Timothy Flynn, DO, Kevin Bergman, MD

Abstract: 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...

(pp 404-410)

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

Joy Shen-Wagner, MD, Michael Wagner, MD, Anthony Hughes, MDiv

Abstract: 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...

(pp 401-403)

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

Benji K. Mathews, MD, Paula E. Miller, MPH, Andrew P.J. Olson, MD

Abstract: 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...

(pp 395-400)

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

Renee K. Dversdal, MD, Kevin M. Piro, MD, Charles M. LoPresti, MD, Noelle M. Northcutt, MD, Daniel J. Schnobrich, MD

Abstract: 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...

(pp 382-388)

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

Keith R. Barron, MD, Joseph C. Lai, DO, Lacey P. MenkinSmith, MD, Jennifer S. Lee, DO, Mark E. Humphrey, MD, MPH, Jeffrey W. Hall, MD

Abstract: 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...

(pp 434-438)

“Old Dogs” Can Learn Ultrasound

Mark H. Greenberg, MD, Janice Boughton, MD, Gregg M. Talente, MD, MS

Abstract: 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...

(pp 421-423)

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

James E. Anstey, MD, Trevor P. Jensen, MD, Nima Afshar, MD

Abstract: 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;...

(pp 444-448)

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

Irene W. Y. Ma, MD, PhD, Chiara Cogliati, MD, Frank H. Bosch, MD, PhD, Ana Claudia Tonelli de Oliveira, MD, PhD, Vincenzo Arienti, MD, Michiel J. Blans, MD, Barry Chan, MB, BCh, Anjali Bhagra, MD

Abstract: 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...

(pp 439-443)

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

Terry K. Rosborough, MD, David M. Tierney, MD

Abstract: 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 for...

(pp 418-420)

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

Jeanette Mladenovic, MD, MBA, MACP, Mary Claire O’Brien, MD, Richard Hoppman, MD

Abstract: 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...

(pp 449-451)

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

Matthew Fentress, MD, DTM&H, Thomas F. Heyne, MD, MSt, Keith R. Barron, MD, Neil Jayasekera, MD

Abstract: 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...

(pp 424-433)