Cardiac Limited Ultrasound Examination Techniques to Augment the Bedside Cardiac Physical Examination.
The current practice of physical diagnosis is dependent on physician skills and biases, inductive reasoning, and time efficiency. Although the clinical utility of echocardiography is well known, few data exist on how to integrate 2-dimensional screening "quick-look" ultrasound applications into a novel, modernized cardiac physical examination. We discuss the evidence basis behind ultrasound "signs" pertinent to the cardiovascular system and elemental in synthesis of bedside diagnoses and propose the application of a brief cardiac limited ultrasound examination based on these signs. An ultrasound-augmented cardiac physical examination can be taught in traditional medical education and has the potential to improve bedside diagnosis and patient care.
Scripps Mercy Hospital, San Diego, California USA (B.J.K., D.J.S., S.A.A., J.N.P.); and University of California, San Diego Medical Center, San Diego, California USA (D.G.B., A.N.D.). kimura.bruce@scrippshealth.org.
Bruce J
BJ
Kimura
Scripps Mercy Hospital, San Diego, California USA (B.J.K., D.J.S., S.A.A., J.N.P.); and University of California, San Diego Medical Center, San Diego, California USA (D.G.B., A.N.D.).
David J
DJ
Shaw
Scripps Mercy Hospital, San Diego, California USA (B.J.K., D.J.S., S.A.A., J.N.P.); and University of California, San Diego Medical Center, San Diego, California USA (D.G.B., A.N.D.).
Stan A
SA
Amundson
Scripps Mercy Hospital, San Diego, California USA (B.J.K., D.J.S., S.A.A., J.N.P.); and University of California, San Diego Medical Center, San Diego, California USA (D.G.B., A.N.D.).
James N
JN
Phan
Scripps Mercy Hospital, San Diego, California USA (B.J.K., D.J.S., S.A.A., J.N.P.); and University of California, San Diego Medical Center, San Diego, California USA (D.G.B., A.N.D.).
Daniel G
DG
Blanchard
Scripps Mercy Hospital, San Diego, California USA (B.J.K., D.J.S., S.A.A., J.N.P.); and University of California, San Diego Medical Center, San Diego, California USA (D.G.B., A.N.D.).
Anthony N
AN
DeMaria
D004452:Echocardiography / Q000295:instrumentation* / Q000379:methods*; D004867:Equipment Design; D019544:Equipment Failure Analysis; D006331:Heart Diseases / Q000000981:diagnostic imaging*; D006801:Humans; D008904:Miniaturization; D010808:Physical Examination / Q000295:instrumentation* / Q000379:methods; D019095:Point-of-Care Systems
continuing medical education; echocardiography; graduate medical education; hand-carried ultrasound; physical examination; physician training; point-of-care ultrasound; screening; stethoscope; vascular ultrasound