Ultrasound Joins Stethoscope as Portable Diagnostic Tool for Hospitalists

Prairie Business Magazine recently reported that hospitalist Neville Alberto, MD, FACP, of Sanford Health in Fargo, N.D., carries on his rounds not a stethoscope but “a portable ultrasound draped around his neck.”¹ The article illustrates ultrasound’s increased portability, wider application at the hospital bedside, and increased use by trained hospitalists. It’s a topic also discussed in a recent post by Robert Wachter, MD, MHM, author of the blog Wachter’s World, professor, and chief of the division of hospital medicine at the University of California at San Francisco (UCSF). Dr. Wachter says “the time has come to—carefully and thoughtfully—add hospitalists” to the growing list of medical specialties that have staked a claim to a procedure previously reserved for radiologists.²

“The one I carry on me is no larger than my smartphone,” Dr. Alberto explains. “It’s well-placed, so nobody notices.”

A hospitalist since 2001, Dr. Alberto is often on the move in his seven-story hospital building. He uses the device to assist in determining whether a patient needs more fluids, or to examine an elderly patient’s bladder for urinary retention when a urinary tract infection is suspected. Only a few colleagues in Dr. Alberto’s 22-member hospitalist group are as comfortable with ultrasound technology, he says, but he has helped develop a curriculum to teach ultrasound techniques to physicians, residents, and medical students.

Diane Sliwka, MD, a UCSF hospitalist and advocate for more widespread ultrasound use by hospitalists, says most physicians have yet to adopt the technology as fully as Dr. Alberto has. “But they’ve seen it and they want it,” she adds.

Hospitalists first utilized portable ultrasound to guide such procedures as thoracentesis or paracentesis. Increasingly, it is being used to assess, for example, cardiac function, fluid buildup around the heart, or the location of a blood clot—“when decisions are needed quickly about what’s going on and how to treat it,” she says. Other growing targets include lung pathologies (pneumothorax) and differentiating between COPD and pulmonary edema, or pneumonia and gallstones, she says.

The technology is advancing faster than the speed of light, with an iPad/tablet application in the works, according to a recent Technology Review blog post from the Massachusetts Institute of Technology.³

References

1. Doctors use technology to better diagnose and treat illnesses in a less invasive manner. Prairie Business website. Available at: www.prairiebizmag.com. Accessed July 31, 2012.
2. Wachter RM. Bedside ultrasound for hospitalists: our time has come. Wachter’s World website. Available at: http://community.the-hospitalist.org/2012/05/16/bedside-ultrasound-for-hospitalists-our-time-has-come. Accessed July 31, 2012.
3. Mims C. Patent hints at iPad-powered portable ultrasound machine. Technology Review website. Available at: www.technologyreview.com/view/427600/patent-hints-at-ipad-powered-portable-ultrasound. Accessed July 29, 2012.