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 literature on simple-to-apply POCUS applications relevant to ambulatory medicine. The topics discussed include detecting left ventricular systolic dysfunction, ascites, gallstones, and Achilles tendon tears, as well as distinguishing abscess from cellulitis. Although a robust literature surrounds POCUS use in EDs, literature is limited regarding POCUS in the ambulatory setting; however, the literature supports general practitioners learning this skill set to the benefit of their patients. As POCUS moves out of hospital EDs and into the clinics, high-quality research demonstrating comparable accuracy and utility will be needed.

Point‐of‐care ultrasound (POCUS) is becoming an essential skill for internists. To date, there are no professional guidelines for how POCUS skills should be taught to medical students. A panel of POCUS experts from seven academic medical centers in the United States was convened to describe the components of independently developed IM clerkship POCUS training programs, identify areas of similarity and difference, and propose recommendations for alignment.

Background In detecting pleural effusion, bedside ultrasound (US) has been shown to be more accurate than auscultation. However, US has not been previously compared to the comprehensive physical examination. This study seeks to compare the accuracy of physical examination with bedside US in detecting pleural effusion. Methods This study included a convenience sample of 34 medical inpatients from Calgary, Canada and Spokane, USA, with chest imaging performed within 24 h of recruitment. Imaging results served as the reference standard for pleural effusion. All patients underwent a comprehensive lung physical examination and a bedside US examination by two researchers blinded to the imaging results. Results Physical examination was less accurate than US (sensitivity of 44.0% [95% confidence interval (CI) 30.0–58.8%], specificity 88.9% (95% CI 65.3–98.6%), positive likelihood (LR) 3.96 (95% CI 1.03–15.18), negative LR 0.63 (95% CI 0.47–0.85) for physical examination; sensitivity 98% (95% CI 89.4–100%), specificity 94.4% (95% CI 72.7–99.9%), positive LR 17.6 (95% CI 2.6–118.6), negative LR 0.02 (95% CI 0.00–0.15) for US). The percentage of examinations rated with a confidence level of 4 or higher (out of 5) was higher for US (85% of the seated US examination and 94% of the supine US examination, compared to 35% of the PE, P < 0.001), and took less time to perform (P < 0.0001). Conclusions US examination for pleural effusion was more accurate than the physical examination, conferred higher confidence, and required less time to complete.

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