Pocket-size hand-held cardiac ultrasound as an adjunct to clinical examination in the hands of medical students and junior doctors.
Vasileios F. Panoulas,Anna-Lena Daigeler,Anura Malaweera,Amrit S. Lota,Dinnish Baskaran,Syed Rahman,Petros Nihoyannopoulos,Petros Nihoyannopoulos +7 more
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TLDR
The use of PHHE after brief bedside training in the form of a tutorial greatly improved the clinical diagnosis of medical students and junior doctors, over and above history, physical examination, and ECG findings.Abstract:
Aims While patient history taking and physical examination remain the cornerstones of patient evaluation in clinical practice, there has been a decline in the accuracy of the latter. Pocket-size hand-held echocardiographic (PHHE) devices have recently been introduced and could potentially improve the diagnostic accuracy of both medical students and junior doctors. The amount of training required to achieve optimal results remains a matter of debate. We hypothesized that the use of PHHE after limited training in the form of a tutorial can improve the clinical diagnosis even in the hands of medical students and inexperienced physicians.
Methods and results Five final-year medical students and three junior doctors without prior echocardiographic experience participated in a standardized 2 h PHHE bedside tutorial. Subsequently, they assessed 122 cardiology patients using history, physical examination, ECG and PHHE. Their final clinical diagnosis was compared against that of a consultant clinician's and also expert in echocardiography. A total of 122 PHHE were performed of which 64 (53%) by final-year medical students and 58 (47%) by junior doctors. Mean ± SD for diagnostic accuracy after history, physical examination, and ECG interpretation was 0.49 ± 0.22 (maximum = 1), whereas the addition of PHHE increased its value to 0.75 ± 0.28 ( Z = −7.761, P <0.001). When assessing left ventricular systolic dysfunction by means of history and physical examination, specificity was 84.9% and sensitivity only 25.9%, whereas after including findings from PHHE, these figures rose to 93.6 and 74.1%, respectively.
Conclusion The use of PHHE after brief bedside training in the form of a tutorial greatly improved the clinical diagnosis of medical students and junior doctors, over and above history, physical examination, and ECG findings.read more
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Focused cardiac ultrasound: recommendations from the American Society of Echocardiography.
Kirk T. Spencer,Bruce J. Kimura,Claudia E. Korcarz,Patricia A. Pellikka,Peter S. Rahko,Robert J. Siegel +5 more
TL;DR: This guideline states that FCU should be used as an Adjunct to Physical Examination when Echocardiography is not Promptly Available and when the patient has no alternative source of care.
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International Evidence-Based Recommendations for Focused Cardiac Ultrasound
Gabriele Via,Arif Hussain,Mike Wells,Robert F. Reardon,Mahmoud Elbarbary,Vicki E. Noble,James W. Tsung,Aleksandar N. Neskovic,Susanna Price,Achikam Oren-Grinberg,Andrew S. Liteplo,Ricardo Cordioli,Nitha Naqvi,Philippe Rola,Jan Poelaert,Tatjana Golob Guliĉ,Erik Sloth,Arthur J. Labovitz,Bruce J. Kimura,Raoul Breitkreutz,Navroz Masani,Justin Bowra,Daniel Talmor,Fabio Guarracino,Adrian Goudie,Wang Xiaoting,Rajesh Chawla,Maurizio Galderisi,Micheal Blaivas,Tomislav Petrovic,Enrico Storti,Luca Neri,Lawrence Melniker +32 more
TL;DR: For the first time, evidence-based clinical recommendations comprehensively address this branch of point-of-care ultrasound, providing a framework for FoCUS to standardize its application in different clinical settings around the world.
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Time to Add a Fifth Pillar to Bedside Physical Examination: Inspection, Palpation, Percussion, Auscultation, and Insonation.
TL;DR: Selective use of bedside ultrasound (or insonation) can be one such strategy that could be incorporated as the fifth component of the physical examination.
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A decade of progress in critical care echocardiography: a narrative review.
Antoine Vieillard-Baron,Antoine Vieillard-Baron,S. J. Millington,Filippo Sanfilippo,Michelle S Chew,José L. Díaz-Gómez,Anthony S. McLean,Michael R. Pinsky,J. Pulido,Paul H. Mayo,N. Fletcher,N. Fletcher +11 more
TL;DR: This narrative review focusing on critical care echocardiography has been written by a group of experts in the field, with the aim of outlining the state of the art in CCE in the 10 years after its official recognition and definition.
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Point of Care Ultrasound: A WFUMB Position Paper
Christoph F. Dietrich,Adrian Goudie,Liliana Chiorean,Xin-Wu Cui,Odd Helge Gilja,Yi Dong,Jacques S. Abramowicz,Sudhir Vinayak,Susan Campbell Westerway,Christian Pállson Nolsøe,Yi-Hong Chou,Michael Blaivas +11 more
TL;DR: The current status and future perspectives of point of care ultrasound are discussed, with particular attention given to the different uses of PoC-US and its clinical significance, including within emergency and critical care medicine, cardiology, anesthesiology, rheumatology, obstetrics, neonatology, gynecology, gastroenterology and many other applications.
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Diagnostic Accuracy of a Hand-Held Ultrasound Scanner in Routine Patients Referred for Echocardiography
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TL;DR: In this article, the authors investigated the imaging capabilities of recent hand-held ultrasound scanners and compared them with high-end echocardiography (HIGH) to assess the left ventricular (LV) dimensions, regional and global LV function, and grades of valve disease.
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