General Internal Medicine, Department of Medicine, Geneva University Hospitals, Geneva, Switzerland.
Emergency Medicine, Department of Acute Medicine, Geneva University Hospitals, Geneva, Switzerland.
Intern Emerg Med. 2020 Apr;15(3):395-408. doi: 10.1007/s11739-020-02284-5. Epub 2020 Feb 7.
The advent of portable devices in the early 80s has brought ultrasonography to the patient's bedside. Currently referred to as 'point of care ultrasonography' (POCUS), it has become an essential tool for clinicians. Initially developed in the emergency and critical care settings, POCUS has gained increasing importance in internal medicine wards in the last decade, with both its growing diagnostic accuracy and portability making POCUS an optimal instrument for everyday clinical assessment and procedures. There is large body of evidence to confirm POCUS' superiority when compared to clinical examination and standard X-ray imaging in a variety of clinical situations. On the contrary, only few indications, such as procedural guidance, have a proven additional benefit for patients. Since POCUS is highly user-dependent, pre- and post-graduate curricula are needed and the range of use should be clearly defined. This review focuses on trends and perspectives of POCUS in the management of diseases frequently encountered in emergency and internal medicine. In addition, questions are raised regarding the teaching and supervision of POCUS needing to be addressed in the near future.
便携式设备于 80 年代初问世,将超声技术带到了患者床边。目前被称为“即时床旁超声检查”(POCUS),它已成为临床医生的基本工具。POCUS 最初在急诊和重症监护环境中开发,在过去十年中,它在内科病房中的重要性日益增加,其日益提高的诊断准确性和便携性使 POCUS 成为日常临床评估和操作的理想工具。有大量证据证实,在各种临床情况下,POCUS 优于临床检查和标准 X 射线成像。相反,只有少数适应证,如程序指导,已被证实对患者有额外益处。由于 POCUS 高度依赖使用者,因此需要进行研究生前和研究生课程,并且需要明确其使用范围。本综述重点介绍了 POCUS 在急诊和内科常见疾病管理方面的趋势和观点。此外,还提出了关于 POCUS 教学和监督的问题,这些问题需要在不久的将来得到解决。