The Medical clinics of North America
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Point-of-care ultrasound (POCUS) bridges diagnostic gaps across the continuum of care worldwide and is a particularly potent tool in resource-limited settings (RLS). To capture the scope of its current impact in RLS, this narrative review of POCUS use in public health, primary care, outpatient specialty, pre-hospital, and palliative care settings discusses its use in reducing diagnostic health care inequities. Disease-specific protocols, longitudinal training, quality assurance, and task shifting are key to robust expansion of POCUS in RLS.
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Med. Clin. North Am. · Jan 2025
ReviewPrinciples of Doppler Ultrasonography and Basic Applications for the Clinician.
Doppler ultrasonography has evolved into a cornerstone of ultrasound imaging. In this article, we delve into the fundamental principles of Doppler ultrasonography, introduce color and spectral Doppler analysis, and highlight common applications relevant to point-of-care (POCUS) practitioners. From enhancing the safety of bedside procedures to estimating cardiac output, to exploring findings of venous congestion, we review the key advantages, disadvantages, and challenges of using Doppler in POCUS.
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Med. Clin. North Am. · Jan 2025
ReviewIntestinal Ultrasound in Common Gastrointestinal Disorders: An Evidence-Based Approach.
Patients with abdominal symptoms are among the most common to present both urgently and non-urgently for medical evaluation. While intestinal ultrasound (IUS) is useful to aid management of these patients, it is not routinely taught, performed, or included as part of the core set of point-of-care ultrasound competencies. The authors present an approach to performing a systematic, but focused, IUS at the bedside and diagnostic accuracies for small bowel obstruction inflammatory bowel disease, appendicitis, and diverticulitis. An approach on how to integrate IUS findings and common pitfalls will also be discussed.
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Point-of-care ultrasound (POCUS) provides immediate and useful information that aids clinical decision making at the bedside. The purpose of this article is to describe how POCUS can be integrated in the evaluation of the urinary system. ⋯ The rest of the article focuses on three common scenarios where POCUS can be integrated into clinical practice: hydronephrosis, nephrolithiasis, and bladder distension. The authors include evidence from the literature and describe commonly encountered pitfalls.
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Integrated multi-organ ultrasound is increasingly used across various medical specialties. It should be performed in conjunction with history, physical examination, and other investigations in the diagnostic process to enhance the detection of conditions in the lung, heart, and abdomen. Multi-organ ultrasound has been shown to improve diagnostic accuracy in a sizeable portion of patients, potentially altering treatment plans. Specifically, it aids in assessing shock, sepsis, dyspnea, delirium, and in the perioperative setting, contributing to a more comprehensive patient assessment process.