Linda Li1, R Jason Yong1, Alan D Kaye2, Richard D Urman3. 1. Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA, 02115, USA. 2. Department of Anesthesiology and Pharmacology, Toxicology, and Neurosciences; Vice Chancellor of Academic Affairs, Chief Academic Officer, and Provost, Louisiana State University School of Medicine, Shreveport, LA, USA. 3. Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA, 02115, USA. rurman@bwh.harvard.edu.
Abstract
PURPOSE OF REVIEW: Point of care ultrasound (POCUS) has played a role across almost every medical specialty. Although anesthesiologists have been using bedside ultrasound for nerve blocks and vascular access for many years now, there has been a recent push to incorporate whole-body POCUS into anesthesiologists' training and daily practice. This article provides a brief overview of the indications, techniques for image acquisition, and general principles in interpreting basic images. RECENT FINDINGS: Whole-body POCUS can provide quick diagnoses and impact clinical management across relevant pre-, intra-, and post-operative settings. Anesthesia providers need to understand different applications for POCUS, including focused cardiac ultrasound (FoCUS), lung ultrasound (LUS), gastric ultrasound, abdominopelvic ultrasound, and the use of ultrasound for airway management. Currently, there is no standard ultrasound curriculum for anesthesiology residents, and teaching methods include informal bedside teaching, structured expert demonstration, didactic lectures, and simulations. Model/simulation-based lecture series may be effective in teaching ultrasound to anesthesiology residents, and e-learning and traditional didactics are both equally effective in teaching POCUS applications such as LUS and focused assessment with sonography in trauma (FAST). Creating protocol-guided frameworks for POCUS, such as I-AIM (indication, acquisition, interpretation, medical decision making), can also ensure more consistent and reliable diagnoses and interpretations of findings. Applications of POCUS should be focused, goal-oriented, easily learned, rapidly performable at bedside, accurate, and reliable. A variety of studies have shown this potential for POCUS in assessing cardiac, pulmonary, and intraabdominal pathologies, making it an emerging area of interest in medicine. The incorporation of POCUS into perioperative medicine provides an important tool to ensure continued improvement in coordinating care for patients in the perioperative period.
PURPOSE OF REVIEW: Point of care ultrasound (POCUS) has played a role across almost every medical specialty. Although anesthesiologists have been using bedside ultrasound for nerve blocks and vascular access for many years now, there has been a recent push to incorporate whole-body POCUS into anesthesiologists' training and daily practice. This article provides a brief overview of the indications, techniques for image acquisition, and general principles in interpreting basic images. RECENT FINDINGS: Whole-body POCUS can provide quick diagnoses and impact clinical management across relevant pre-, intra-, and post-operative settings. Anesthesia providers need to understand different applications for POCUS, including focused cardiac ultrasound (FoCUS), lung ultrasound (LUS), gastric ultrasound, abdominopelvic ultrasound, and the use of ultrasound for airway management. Currently, there is no standard ultrasound curriculum for anesthesiology residents, and teaching methods include informal bedside teaching, structured expert demonstration, didactic lectures, and simulations. Model/simulation-based lecture series may be effective in teaching ultrasound to anesthesiology residents, and e-learning and traditional didactics are both equally effective in teaching POCUS applications such as LUS and focused assessment with sonography in trauma (FAST). Creating protocol-guided frameworks for POCUS, such as I-AIM (indication, acquisition, interpretation, medical decision making), can also ensure more consistent and reliable diagnoses and interpretations of findings. Applications of POCUS should be focused, goal-oriented, easily learned, rapidly performable at bedside, accurate, and reliable. A variety of studies have shown this potential for POCUS in assessing cardiac, pulmonary, and intraabdominal pathologies, making it an emerging area of interest in medicine. The incorporation of POCUS into perioperative medicine provides an important tool to ensure continued improvement in coordinating care for patients in the perioperative period.
Entities:
Keywords:
Anesthesia; Bedside ultrasound; FAST; FoCUS; POCUS; Point of care ultrasound; Ultrasound
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