ASRA Pain Medicine Update

“Seeing Is Believing” - Introduction to Perioperative Point-of-Care Ultrasound

Aug 30, 2016

Stephen Haskins, MD, and Jan Boublik, MD, PhD

As perioperative anesthesiologists, we work in a fast-paced environment where we often have to make critical decisions for patients with rapidly evolving pathology and clinical scenarios. These potentially life-saving interventions are made without the luxury of time for a complete assessment or ordering of advanced imaging. Therefore, emergencies inherently result in gaps in clinical evidence and the potential for suboptimal management.

The idiom “seeing is believing” means that only physical or concrete (i.e., visible) evidence is convincing. In these emergent and critical scenarios, point-of-care ultrasound (POCUS) has proven itself to be a powerful tool to obtain concrete evidence to either confirm or rule out obvious, yet potentially life-threatening pathology. 

POCUS allows for rapid diagnosis of a wide range of pathology, including pneumothorax, hemothorax, pulmonary embolism, hypovolemia, global cardiac dysfunction, and abdominal compartment syndrome, just to name a few. More importantly, it guides appropriate management. For example, the ability to differentiate between a hypovolemic patient needing fluid resuscitation compared to a patient with poor cardiac function in need of an inotrope is essential. Far too often, we have to make assumptions based on medical history and external assessment – but now we have ultrasound as a tool to look inside of these patients and guide management.

As ultrasound technology has improved in image quality and portability while simultaneously decreasing in cost and size, it has now become ubiquitous. Bedside ultrasound in the form of POCUS has the potential to become the “21st century stethoscope,” which will be a significant technological evolution for our profession. But, this evolution requires training of our current and future generations of anesthesiologists.

The ASRA Introduction to Perioperative Point-of-Care Ultrasound course teaches POCUS fundamentals and provides the skills needed to start utilizing this powerful tool so you can believe what you see and act quickly, all the while avoiding inaccurate diagnosis or management.


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