The Medical clinics of North America
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Abdominal point-of-care ultrasound is an essential diagnostic tool for internal medicine physicians. It can identify intraperitoneal free fluid, evaluate the liver for size, presence of steatosis, and assessment for possible cirrhosis. ⋯ In such cases, sonographic measurements may provide a more definitive diagnosis. With the proper training, these organs can be evaluated at the bedside and guide clinical decision making.
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Med. Clin. North Am. · Jan 2025
ReviewAdvanced Cardiac Point-of-Care Ultrasound: A Systematic Review of Select Cardiac Diseases.
Basic cardiac point-of-care ultrasound (POCUS)/focused cardiac ultrasound (FoCUS) often reveals incidental findings. Consider a patient with dyspnea in whom FoCUS reveals left ventricular (LV) hypertrophy, calcified valves, and pericardial effusion but "normal" LV systolic function. ⋯ This systematic review identified studies suggesting that a sufficiently trained practitioner can leverage advanced techniques to evaluate conditions such as hypertrophic cardiomyopathy (4), LV diastolic dysfunction (6), severe valvular heart disease (6), and tamponade (8). This article discusses the use of advanced cardiac POCUS in these conditions.
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Med. Clin. North Am. · Jan 2025
ReviewBasic Lung Ultrasound and Clinical Applications in General Medicine.
Proficiency in basic lung ultrasound is highly recommended for clinicians in general and internal medicine. This article will review and provide guidance for novice users on how to use lung ultrasound in clinical practice, through a pathology-oriented approach. The authors recommend a 12-zone protocol and describe how to perform and apply it in clinical practice while examining patients with clinical suspicion for the following diseases: pleural effusion, heart failure, pneumonia (bacterial and viral), interstitial lung disease, and pneumothorax.
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Med. Clin. North Am. · Jan 2025
ReviewPrinciples and Practice of Internal Medicine Point-of-Care Ultrasound.
While point-of-care ultrasound (POCUS) use is expanding within Internal Medicine, basic yet important practices and key infrastructure are frequently underutilized. This is appropriately raising concerns that patients may be unintentionally harmed by POCUS. ⋯ It is also important to build infrastructure to allow for ongoing monitoring and quality assurance with an emphasis on transparency and objectivity of the clinician's POCUS findings. This will ensure the safe and effective integration of POCUS in Internal Medicine.
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Errors and pitfalls associated with the performance of point-of-care ultrasound (POCUS) are common and can stem from errors in image acquisition, interpretation, and clinical integration. In this article, the author discuss the technical and cognitive mechanisms involved and propose a framework in systematically approaching potential errors in POCUS, as well as strategies to mitigate them.