The Curbsiders Internal Medicine Podcast #108: Point-of-care Ultrasound for the Internist
11 snips
Aug 13, 2018 Renee Dversdal, associate professor and director of OHSU’s Point of Care Ultrasound program, shares her POCUS journey and training work. Conversations cover what bedside ultrasound is vs formal studies. Short segments explore handheld devices, training pathways and competency, practical use for hypotension and outpatient workflows, and tips on documentation and integrating POCUS into the physical exam.
AI Snips
Chapters
Books
Transcript
Episode notes
Match Device Choice To Clinical Workflow
- Choose devices based on workflow needs: handhelds (<$2k–$10k) offer portability; wheeled cart machines provide multi-probe imaging and archiving.
- Plan checkout systems for shared handhelds to prevent loss and ensure access for trainees.
Scan To Answer Specific Clinical Questions
- Use focused goals when scanning: list questions first then perform targeted cardiac, lung, and IVC views to answer them.
- In the TAVR patient example, bedside POCUS avoided diuresis and led to giving fluids based on collapsed IVC and neck ultrasound.
Use IVC For Extremes Not Precise Volume Guidance
- IVC measurements are useful at physiological extremes but unreliable in the middle or during positive-pressure ventilation.
- Renee uses IVC to detect grossly high vs low right atrial pressure rather than precise volume responsiveness.
