Point-of-care cardiac ultrasound in acute medicine – the quick scan

• Published in: Clinical medicine (London, England) Vol. 14; no. 6; pp. 608 - 611
• Main Authors: Hothi, Sandeep S., Sprigings, David, Chambers, John
• Format: Journal Article
• Language: English
• Published: London Elsevier Ltd 01.12.2014; Royal College of Physicians
• Subjects: acute medicine; Biological and medical sciences; Cardiovascular system; Clinical Practice; echocardiography; Echocardiography - instrumentation; Echocardiography - methods; Emergency Medicine - instrumentation; Emergency Medicine - methods; General aspects; hand-held ultrasound; Humans; Investigative techniques, diagnostic techniques (general aspects); Medical sciences; physical examination; Physical Examination - instrumentation; Physical Examination - methods; point-of-care; Point-of-Care Systems; Quick-scan; Ultrasonic investigative techniques; acute medicine; physical examination; Quick-scan; point-of-care; hand-held ultrasound; echocardiography; Sonography; Heart; Point-of-care testing; Echocardiography; Acute; Medicine; Point of care testing; Portable equipment; Clinical investigation; Circulatory system; Ultrasound; Semiology
• ISSN: 1470-2118; 1473-4893
• DOI: 10.7861/clinmedicine.14-6-608

The optimum management of acute medical patients requires prompt and accurate diagnosis, monitoring and treatment. The clinical history and physical examination remain central to diagnosis, but often need supplementation by laboratory testing or imaging. Echocardiographic assessment of cardiac structure and function provides valuable information that can aid diagnosis and assess clinical progress. It has many advantages as an imaging modality, and recent technological advances have resulted in hand-held, battery-powered ultrasound devices that provide high-quality images. Three broad applications of cardiac ultrasound now exist: conventional echocardiography, focussed echocardiography and the quick-scan. A quick-scan using a hand-held ultrasound device is readily integrated into the bedside clinical assessment, providing information that can be used immediately in diagnostic reasoning; it can also guide pericardiocentesis. Hand-held ultrasound devices can also be used in acute situations, as well as geographically remote areas or special situations (eg disaster zones) where other imaging is not available. However, the diagnostic yield of echocardiography is user dependent, and training is required for its benefits to be realised, adding to the hardware costs. More data are needed on the incremental value of hand-held ultrasonography and a quick-scan over conventional methods of assessment, their impact on clinical outcomes, and cost effectiveness.