Physical exam with ultrasound, lights and shadows of an unstoppable multidisciplinary advance

Tung-Chen, Y.; Martí-de Gracia, M.

doi:10.1016/j.rceng.2024.02.006

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Tung-Chen, M. Martí-de Gracia" "autores" => array:2 [ 0 => array:4 [ "nombre" => "Y." "apellidos" => "Tung-Chen" "email" => array:1 [ 0 => "yale.tung@salud.madrid.org" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "*" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "M." "apellidos" => "Martí-de Gracia" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "b" "identificador" => "aff0010" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Coordinador del Grupo de Trabajo de Ecografía Clínica de la Sociedad Española de Medicina Interna (GTECo-SEMI), Servicio de Medicina Interna, Hospital Universitario La Paz; Departamento de Medicina, Universidad Alfonso X El Sabio, Madrid, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Presidenta saliente de la Sociedad Española de Radiología Médica (SERAM) y Sociedad Española de Radiología de Urgencias (SERAU), Jefa de Sección de Radiología de Urgencias, Hospital Universitario La Paz, Madrid, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "La exploración física con ultrasonidos, luces y sombras de un avance multidisciplinar imparable" ] ] "textoCompleto" => "Ultrasound has expanded considerably in recent years and is currently used by multiple specialists classically unrelated to imaging techniques and applied at the patient bedside. This has led to the concept of PoCUS (Point-of-Care UltraSound). In this regard, PoCUS is regarded as a complementary tool to physical examination that allows for a more precise and agile approach, guiding the diagnosis and treatment, and monitoring or guiding minimally invasive procedures with greater patient safety.<a class="elsevierStyleCrossRef" href="#bib0005">1</a> It has thus become the fifth cornerstone of the exploration procedure: inspection, palpation, percussion, auscultation and insonation.<a class="elsevierStyleCrossRef" href="#bib0010">2</a>The time taken to perform the examination is usually shorter than for a standard protocolized study, since its purpose is very specific and with a very defined protocol, and the knowledge of the person performing it is also often more limited.<a class="elsevierStyleCrossRef" href="#bib0015">3</a> In specific clinical scenarios, the exploration of one or more foci of interest, simultaneously or consecutively, allows a large amount of relevant information to be obtained quickly and in a noninvasive manner. The objectives and exploration process are specific to each protocol, and aim to resolve practical management issues in a short time, limited to the area of interest of each medical specialty in a given moment: Is there free fluid in this patient? Is there a decrease in left ventricular ejection fraction? Is there urine retention?, etc. On the other hand, the technique may also facilitate procedures (catheterization, thoracocentesis, paracentesis, fine needle aspiration, etc.), perform a multiorgan examination in certain clinical scenarios (arterial hypotension, assessment of cardiovascular risk, etc.), or monitor the patient course or response to treatment, such as fluid supply, the evolution of pneumonia with antibiotic therapy, or the detection of early complications after thoracocentesis.Scientific societies have included training, research and the promotion of this area of competence among their strategic objectives.<a class="elsevierStyleCrossRef" href="#bib0020">4</a> In fact, it is already widely recognized that PoCUS is changing our professional practice, thanks also to advances in equipment miniaturization and the introduction of artificial intelligence programs that will facilitate access to the technique.<a class="elsevierStyleCrossRef" href="#bib0005">1</a>PoCUS is here to stay. Given its potential, it is crucial for scientific societies to establish a standardized training plan in order to generalize the correct use of the technique.<a class="elsevierStyleCrossRefs" href="#bib0005">1,4,5</a> It is important to be able to convey not only what the benefits are, but above all also the limitations of the technique carried out with the diversity of current equipment and with less thorough training. The fact that PoCUS is noninvasive does not mean that there are no risks associated with the indication of use, the training of the operator, the quality of the data obtained, their interpretation, and the resulting decisions made. It cannot be sufficiently stressed that, like any other imaging technique, PoCUS must be performed under the same rigorous quality standards as any other specialty such as Cardiology or Radiology.<a class="elsevierStyleCrossRef" href="#bib0025">5</a> Failure to do so may cause harm to our patients.<a class="elsevierStyleCrossRef" href="#bib0030">6</a>In conclusion, PoCUS is an imaging technique not limited to a given specialty, protocol or organ.<a class="elsevierStyleCrossRef" href="#bib0005">1</a> Consequently, collaborative multidisciplinary efforts should focus on adequate training, through the accreditation of specific competences, research and promotion, guaranteeing correct application of the technique at the right time,<a class="elsevierStyleCrossRef" href="#bib0035">7</a> for the benefit of patients as our true points of care." 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Braunwald" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "JAMA Cardiol" "fecha" => "2018" "volumen" => "3" "paginaInicial" => "346" "paginaFinal" => "350" ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0015" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The inevitable lightness of echocardioscopy: teamwork, training and quality assurance are indispensable" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "E. Cascos" 1 => "M. Sitges" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.rec.2022.09.003" "Revista" => array:6 [ "tituloSerie" => "Rev Esp Cardiol (Engl Ed)" "fecha" => "2023" "volumen" => "76" "paginaInicial" => "83" "paginaFinal" => "85" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/36245100" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0020" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Consensus document of the SEMI, semFYC, SEN, and SEC on focused cardiac ultrasound in Spain" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "L. Pérez de Isla" 1 => "S. Díaz Sánchez" 2 => "J. Pagola" 3 => "G. García de Casasola Sánchez" 4 => "T. López Fernández" 5 => "I.M. Sánchez Barrancos" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Rev Espanola Cardiol Engl Ed" "fecha" => "2018" "volumen" => "71" "paginaInicial" => "935" "paginaFinal" => "940" ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0025" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Canadian Association of Radiologists position statement on point-of-care ultrasound" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "T.P. Chawla" 1 => "M. Cresswell" 2 => "S. Dhillon" 3 => "M.L.C. Greer" 4 => "A. Hartery" 5 => "V. Keough" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Can Assoc Radiol J" "fecha" => "2019" "volumen" => "70" "paginaInicial" => "219" "paginaFinal" => "225" ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0030" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Executive summary of the consensus document for the training and development of clinical ultrasound in Internal Medicine: Recommendations from the Clinical Ultrasound Working Group of the Spanish Society of Internal Medicine (GTECO-SEMI)" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "Y. Tung-Chen" 1 => "G. García de Casasola Sánchez" 2 => "S. García Rubio" 3 => "L. Beltrán Romero" 4 => "M. Bernabéu Wittel" 5 => "L.S. CastroBriongos Figuero" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.rceng.2023.12.006" "Revista" => array:7 [ "tituloSerie" => "Rev Clin Esp (Barc)" "fecha" => "2024" "volumen" => "224" "numero" => "1" "paginaInicial" => "57" "paginaFinal" => "63" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/38142977" "web" => "Medline" ] ] ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib0035" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The point of care" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "S.E. Wiegers" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.echo.2016.02.007" "Revista" => array:5 [ "tituloSerie" => "J Am Soc Echocardiogr" "fecha" => "2016" "volumen" => "29" "paginaInicial" => "A19" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27816148" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/22548874/0000022400000003/v1_202403090824/S2254887424000249/v1_202403090824/en/main.assets" "Apartado" => array:4 [ "identificador" => "72714" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Editorials" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/22548874/0000022400000003/v1_202403090824/S2254887424000249/v1_202403090824/en/main.pdf?idApp=WRCEE&text.app=https://revclinesp.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2254887424000249?idApp=WRCEE"]

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Vol. 224. Issue 3.

Pages 187-188 (March 2024)

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