Diprose William, Verster Francois, Schauer Cameron
Whangarei Hospital, Northland DHB, Whangarei.
General Medical Department, Northland DHB, Whangarei.
N Z Med J. 2017 Jan 27;130(1449):46-51.
The art of physical examination has continued to be practised by physicians largely unchanged for over 200 years. Ultrasound, once the domain of the radiologist, is now being increasingly used by emergency physicians and intensivists to make rapid, accurate diagnoses at the point-of-care. We review the growing body of evidence supporting point-of-care ultrasound (PoCUS) as the preferred alternative to many aspects of the cardiovascular, respiratory, abdominal and neurological examinations in internal medicine. Compared with physical examination, PoCUS may increase diagnostic accuracy and patient satisfaction; reduce unnecessary investigations and healthcare costs; be shared with experts for a second opinion; and have automated decision-support applied to improve diagnosis. Further research is needed to identify the ideal combination of physical and PoCUS techniques to establish a gold-standard 'hybrid' approach to bedside assessment.
体格检查技术在200多年来一直被医生沿用，基本没有变化。超声检查曾经是放射科医生的专属领域，如今急诊科医生和重症监护医生越来越多地使用它在床边进行快速、准确的诊断。我们回顾了越来越多的证据，这些证据支持床旁超声检查（PoCUS）可作为内科心血管、呼吸、腹部和神经检查诸多方面的首选替代方法。与体格检查相比，床旁超声检查可能会提高诊断准确性和患者满意度；减少不必要的检查和医疗费用；与专家共享以获得二次诊断意见；并应用自动化决策支持来改善诊断。需要进一步研究以确定体格检查和床旁超声检查技术的理想组合，从而建立一种黄金标准的“混合”床边评估方法。
