Introduction to Perioperative Point-of-Care Ultrasound - “Seeing Is Believing”By Stephen Haskins, MD, and Jan Boublik, MD, PhD Aug 1, 2016
Stephen Haskins, MD
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 to be a powerful tool to obtain concrete evidence to either confirm or rule out severe and potentially life threatening conditions.
Jan Boublik, MD, PhD
PoCUS allows for rapid diagnosis of a wide range of pathology, including: pneumothorax, pleural effusion (as in hemothorax), hypovolemia, global cardiac dysfunction and free fluid in the abdomen. PoCUS can also provide significant ultrasound evidence to either increase suspicion for or potentially rule out a pulmonary embolism. Most importantly, PoCUS guides appropriate management. For example, the ability to differentiate between a hypovolemic patient needing fluid resuscitation and a patient with poor cardiac function in need of an inotrope is essential! Far too often we have to make assumptions based on limited medical history and external assessment – but now we have ultrasound as a tool to “look” inside the patient and guide management.
... the ability to differentiate between a hypovolemic patient needing fluid resuscitation and a patient with poor cardiac function in need of an inotrope is essential
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 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.
We encourage you to learn more and share your thoughts about PoCUS through the course and these other resources:
- Read "Why PoCUS" to learn more about the development of the course.
- Visit the Perioperative Point-of-Care Ultrasound Special Interest Group (SIG) page and learn about the SIG’s goals to advance understanding and use of PoCUS.
- Read about the use of PoCUS related to lung ultrasonography.
- Tell us what you think about using PoCUS in your practice by answering our latest poll question.
Also, check out the latest episode of ASRA RAPP — Regional Anesthesia and Pain Podcast — where we are interviewed by Raj Gupta, MD, and Eric Schwenk, MD.
Stephen Haskins, MD, is a clinical assistant professor of Anesthesiology at Weill Cornell Medical College and an assistant attending anesthesiologist at the Hospital for Special Surgery in New York City. Jan Boublik, MD, PhD, is an assistant professor of Anesthesiology at Stanford University in Stanford, CA. Dr. Haskins and Dr. Boublik are members of the Scientific/Education Planning Committee and faculty for the Introduction to Perioperative Point-of-Care Ultrasound Course.