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Saturday Nov 21, 2020

Five simple procedures for point-of-care ultrasound beginners

Ultrasound devices are more portable and affordable than ever and have head-to-toe applications for primary care. But primary care physicians shouldn’t start with complicated, high-stakes procedures like scanning for deep vein thrombosis.

The best procedures for point-of-care ultrasound beginners to start with are those that are impactful for the patient, easy to perform (require a small number of quickly obtained views), simple to interpret (limited diagnostic endpoints), and low liability for both patient and physician.

Here are small examples from different anatomical groups:

1. Cellulitis vs. abscess (skin and soft tissue): An ultrasound can quickly tell you whether tissue is cellulitic or whether an abscess has formed underneath. Just look for the fluid pocket on the scan. Once you’ve mastered that skill, you can move on to using ultrasound to evaluate lumps and bumps on the skin.

2. Knee effusions (musculoskeletal): Using ultrasound to check for excess fluid around the knee (or other joints) is similarly simple to checking for an abscess. Once you master that, you can move on to using the ultrasound to guide injections to treat effusions or other conditions.

3. Bladder obstruction (pelvis and abdomen): Obstructions should be relatively easy to find on an ultrasound with transducers set to low frequency. Mastering this will help you eventually use ultrasound for intrauterine pregnancy labor and delivery, if that’s part of your practice.

4. Abdominal ascites (abdomen): The abdomen is another area of the body where the buildup of fluid can be easily identified with an ultrasound. Once you’ve mastered that, you’ll be better able to identify hydronephrosis using ultrasound as well.

5. Pleural effusion (chest): If one of the lungs appears compressed on the ultrasound, you may be able to identify a fluid pocket pushing against it. Mastering this is a step toward using ultrasound to identify pulmonary edema.

Read the full FPM article: “Point-of-Care Ultrasound: A Practical Guide for Primary Care.”

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Posted at 11:45PM Nov 21, 2020 by FPM Editors

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