title: Point-of-care cardiac ultrasound in acute medicine--the quick scan.
abstract: 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.
authors.affiliation: Murray Edwards College, University of Cambridge, Cambridge, UK, and clinical lecturer in cardiology, Glenfield Hospital, Leicester, UK ssh26@cam.ac.uk.
authors.forename: Sandeep S
authors.initials: SS
authors.lastname: Hothi
authors.affiliation: Northampton General Hospital, Northampton, UK.
authors.forename: David
authors.initials: D
authors.lastname: Sprigings
authors.affiliation: Guy's and St Thomas' Hospital, London, UK.
authors.forename: John
authors.initials: J
authors.lastname: Chambers
mesh_terms: D004452:Echocardiography / Q000295:instrumentation* / Q000379:methods; D004635:Emergency Medicine / Q000295:instrumentation* / Q000379:methods; D006801:Humans; D010808:Physical Examination / Q000295:instrumentation* / Q000379:methods; D019095:Point-of-Care Systems
keywords: Quick-scan; acute medicine; echocardiography; hand-held ultrasound; physical examination; point-of-care