May 31, 2013 — The American Society of Echocardiography (ASE) released a new expert consensus statement this week focusing on the practice of using ultrasound as a tool for improving patient physical examinations. “Focused Cardiac Ultrasound: Recommendations from the American Society of Echocardiography” will appear in the June issue of the Journal of the American Society of Echocardiography (JASE).
The recent improvements in portability of cardiovascular ultrasound equipment have had a significant impact on its use in medical practice. As such, this new recommendation aims to inform the medical community and define how focused cardiac ultrasound (FCU) can be used to positively impact patient care. Technological advances have resulted in a growth in cardiac ultrasound images being procured by a variety of specialists and generalists in a range of settings, such as outpatient clinics, inpatient wards, critical care units, emergency departments and remote clinics. With the creation and publication of these recommendations, ASE is identifying how practitioners with limited training can appropriately use portable devices to expedite and improve the quality of patient care.
“The development of small, inexpensive, portable ultrasound devices, combined with a growing interest of physicians in many specialties to use ultrasound at the bedside for point-of-care assessment, prompted the American Society of Echocardiography to develop this expert consensus document,” said Patricia Pellikka, M.D., FASE, a cardiologist at Mayo Clinic and president of ASE. “This document establishes definitions for focused cardiac ultrasound, describes its appropriate application and discusses issues of training for the user. It will be a valuable reference for ASE members and for the medical community at large.”
This document will change practice for clinicians by encouraging additional training in light of the significant role the comprehensive transthoracic echocardiogram (TTE) has in the proper care and treatment of the heart patient. Key information obtained during the TTE is crucial in initiating proper therapies and in the evaluation of abnormalities. FCU is a focused examination of the cardiovascular system performed by a physician using ultrasound as an adjunct to the physical examination to recognize specific ultrasonic signs that represent a narrow list of potential diagnoses in specific clinical settings. The document distinguishes the emerging field of FCU as a bedside adjunct to the physical examination and echocardiography. Defining the distinctions between these techniques will allow practitioners to realize the utility of FCU while maintaining the value of echocardiography.
“Recent advances have resulted in the development of small platforms which have brought the power of ultrasound to the bedside,” said Kirk T. Spencer, M.D., FASE, cardiologist at the University of Chicago and ASE’s Guidelines and Standards Committee chairman, who served as the lead author of the guideline. “Physicians from diverse specialties, who have less training in cardiac image acquisition and interpretation compared to those trained in echocardiography, can learn to acquire and interpret cardiac ultrasound images as an adjunct to their physical examination assessment in clinical settings relevant to their scope of practice.”