POCUS: The Next Stethoscope
The invention of the stethoscope in the 1800s was a milestone in medicine. It revolutionized how physicians assessed patients, allowing for quick diagnosis of life-threatening illnesses. Despite more than a century past, findings with the stethoscope continue to guide our everyday clinical decision making.
I believe that the next invention to make as big of an impact on the physicians physical exam is the point of care ultrasound, also known as POCUS.
While it is not new technology per se, the improved portability of the new ultrasound probes and the decrease in cost of the technology has made it more accessible for everyday use. Medical schools are starting to slowly introduce ultrasound use into their curriculum. I believe that within the next decade every medical student will begin to carry a portable ultrasound probes the way ophthalmoscopes were carried by physicians in the 1950s.
Already well established in the field of emergency medicine in the assessment of trauma patients, the modality is slowly beginning to be used on the wards by general practitioners. Whether it is assessment of undifferentiated shock, evaluating for causes of dyspnea, or evaluating heart function, real-time imaging with the ultrasound has the potential to guide differentials fast and with accuracy. Instead of waiting hours or days for a formal transthoracic echocardiography or a chest x-ray, we can quickly diagnose life-threatening pathology such as tamponade or pneumothorax.
As with any skill in medicine, experience is the only way to improve in POCUS use. For those interested, the first step in learning how to use the ultrasound begins with learning how to find and assess the proper windows. From there, it is a matter of continuously using the ultrasound and correlating findings to prior formal imaging studies.