Handheld ultrasound: Can the line and near hand-held ultrasound replace the stethoscope?

Handheld ultrasound (HHUS) Handheld ultrasound has become a useful auxiliary auscultation instrument that plays an important role in medical education and physical diagnosis. Dr. Barclay pointed out that it is uncertain whether HHUS will become a future stethoscope. Professor Scott D. of Harvard Medical School believes that “a new generation of doctors needs to see Portable Ultrasound as an extension of their senses. Handheld ultrasound technology requires medical school recognition and the technology throughout the entire medical curriculum.”

In 1816 the French doctor Renek invented the stethoscope. Almost all doctors have used stethoscopes for the next two centuries. In addition to electronic stethoscopes that amplify signals and filtering, there is little progress in stethoscope styles and techniques. Ultrasound can provide anatomical and functional information without ionizing radiation. In the past five years, ultrasound has largely replaced stethoscopes in cardiovascular, maternal and gastrointestinal diseases. At present in the cardiovascular department, echocardiography is the most commonly used and most economical examination.

With HHUS doctors, you can quickly make a diagnosis at the bedside. The emergency department has been trained to perform abdominal and cardiac ultrasound examinations. HHUS is also used in obstetrics, intensive care ultrasound, and catheter replacement. In African villages, midwives use HHUS to diagnose fetal abnormalities and improve the survival rate of cesarean section mother and child. Rapid diagnosis of acute pulmonary embolism in elderly patients with non-ST-segment elevation myocardial infarction by HHUS, patients immediately underwent chest CT and timely treatment. Through the HHUS check, choose the right treatment to avoid unnecessary risks and expenses.

The cost and volume of ultrasound equipment previously limited the popularity of ultrasound equipment. As the microprocessor gets faster and smaller, the full power of ultrasound can be done on a laptop, and even the instrument can be placed in a pocket. Dr. Moore estimates that the current HHUS price for emergency and ICU use is between $8,000 and $10,000. He predicts that in the next decade, it will drop to $2,000, which is acceptable to private doctors' clinics. Dr. Solomon and others believe that HHUS can surpass the stethoscope.

For freshmen who are trained in HHUS use, the accuracy of diagnosis of cardiac abnormalities is higher than that of experts who often use stethoscopes. The University of California, Harvard University, etc. have recently added ultrasound training to undergraduate programs. HHUS is easy to operate, but it is difficult to master, so it is necessary to carry out ultrasound training as early as possible in medical education. Freshman students have limited ability to focus their focus on the heart, and juniors have a good grasp of scanning techniques, image acquisition and analysis capabilities. Expert guidance is very important for developing scanning techniques.

Dr. Mulvagh and others advocate that HHUS can be used as an extension of the stethoscope, not a substitute. HHUS is designed to diagnose or exclude suspected pathological diagnoses by ultrasound-assisted clinical diagnosis, as seen or not seen by ultrasound images. HHUS needs two improvements. In terms of technology, the size is smaller and the design is more ergonomic, such as lung breath sounds and bowel sounds. In education, doctors must be made to view HHUS as an extension of the senses and continue to follow the medical education process throughout the medical education curriculum.

HHUS barriers to access include the use of an experienced sonographer to guide the use of the instrument and the retention of images, false negatives and false positives, which may reduce the use of traditional physical examination by medical students. Dr. Mulvagh and other scholars have suggested studying how to incorporate ultrasound into medical education programs. With the advancement of HHUS technology, we can soon see with interest that patients are looking forward to expecting doctors to use HHUS skillfully.