Point-of-care ultrasonography.

Copyright © 2011 Massachusetts Medical Society. Ultrasonography is a safe and effective form of imaging that has been used by physicians for more than half a century to aid in diagnosis and guide procedures. Over the past two decades, ultrasound equipment has become more compact, higher quality, and less expensive, which has facilitated the growth of point-of-care ultrasonography — that is, ultrasonography performed and interpreted by the clinician at the bedside. In 2004, a conference on compact ultrasonography hosted by the American Institute of Ultrasound in Medicine (AIUM) concluded that “the concept of an ‘ultrasound stethoscope’ is rapidly moving from the theoretical to reality.” This conference included representatives from 19 medical organizations; in November 2010, the AIUM hosted a similar forum attended by 45 organizations.1-3 Some medical schools are now beginning to provide their students with hand-carried ultrasound equipment for use during clinical rotations.4 Although ionizing radiation from computed tomographic (CT) scanning is increasingly recognized as a potentially major cause of cancer, ultrasonography has been used in obstetrics for decades, with no epidemiologic evidence of harmful effects at normal diagnostic levels.5,6 However, ultrasonography is a user-dependent technology, and as usage spreads, there is a need to ensure competence, define the benefits of appropriate use, and limit unnecessary imaging and its consequences.7-10 This article provides an overview of the history and current status of compact, point-of-care ultrasonography, with examples and discussion of its use.