Point-of-Care Cardiac Ultrasound: Feasibility of Performance by Noncardiologists

Abstract

Cardiac ultrasound has been used for decades to assess a wide variety of structural and functional pathology, as well as to monitor response to therapy. It offers the advantages of noninvasive, real-time dynamic functional assessment without the risk of radiation. Cardiologists have traditionally employed this modality and have established robust guidelines on the use of echocardiography. However, other specialties such as emergency medicine and critical care have realized the benefit of cardiac ultrasound and have established specialty guidelines in its use. There is growing evidence for the benefit of cardiac ultrasound at the point of care on hospital wards, clinics, and even pre-hospital environments as well. The pervasive use of focused ultrasound is perhaps most evident in the advent of ultrasound training in undergraduate medical curricula. This paper reviews some of the key literature on the use of focused, point-of-care ultrasound by noncardiologists. Feasibility, clinical utility, and emerging trends are reviewed.

Ultrasound Curricula in Undergraduate Medical Education: A Scoping Review

“…Numerous institutions, including the Wayne State University School of Medicine, Ohio State University College of Medicine, University of California, Irvine, and University of South Carolina School of Medicine, have developed longitudinal US curricula that span the duration of medical school and are incorporated into gross anatomy, physiology, pathology, and clinical skill courses (Table ) . The goals of the multimodal US curricula are to familiarize students with point‐of‐care US equipment, US imaging techniques, image acquisition, interpretation of normal anatomy and pathologic conditions, and the use of point‐of‐care US in clinical decision making …”

Focus-assessed transthoracic echocardiography: Implications in perioperative and intensive care

“…[14] Its application is distinct as a guide to pericardiocentesis and confirmation of transvenous pacing wire placement. [16]…”

Handheld Echocardiography in a Clinical Practice Scenario: Concordances Compared to Standard Echocardiographic Reports

“… 3) 4) 5) 6) 7) 8) 9) 10) 11) HH echocardiography has already proved to be a reliable tool in clinical examination and for the screening of several cardiovascular disorders. 3) 5) 6) 7) 9) 11) 12) 13) 14) 15) 16) 17) 18) 19) 20) 21) 22) 23) 24) 25) 26) 27) 28) 29) 30) 31) Although the initial intuitive reaction is that the HH device would be significantly useful, its image quality does not match that of high-definition machines, which may affect study quality. Other limitations for its broad use center on the fact that the knowledge about this technique derives from small studies with unselected patients and limited scope of diagnostic comparison.…”