Better Care at the Bedside with Point-of-Care Ultrasound

by Osler Staff | Jun 04, 2018

Osler’s Dr. Jeff Handler says point-of-care ultrasound (POCUS) is revolutionizing patient care, allowing physicians to provide better, more efficient bedside care.

POCUS uses an ultrasound emitting probe that enables direct visualization of body organs in real time. Coupled with the traditional patient history and physical examination, it enhances diagnostic and procedural accuracy to very close to the traditional gold standard Computed Tomography (CT) scans for many critical patient conditions.

It is more accurate than a chest x-ray for basic respiratory conditions such as Chronic Obstructive Pulmonary Disease (COPD), asthma, pneumonia, pneumothorax and congestive heart failure. In other conditions, such as pulmonary embolism, POCUS can assist with methodology to minimize CT Scanning to only those patients predicted to be at high risk and, in some of these cases, allow for immediate lifesaving therapy.

Often referred to as the stethoscope of the 21st century, Dr. Handler, a physician in the ED and POCUS Director , says this portable technology is fast becoming a “translational tool” applied not only in emergency and critical care patients but to other disciplines as well, including Urgent Care, Nephrology, Oncology, Palliative Care, Anesthesia, and beyond.

Today, POCUS is being used at Osler to:

  • improve accuracy when setting broken bones in children;
  • provide nerve block pain control for hip fractures in the elderly, minimizing risk of delirium;
  • provide rapid real time diagnostics of retinal detachment;
  • facilitates and/or expedites rapid internal medicine consultation for admission to hospital;
  • and much more

Osler’s POCUS program has been growing steadily since the late 1990s, with the first POCUS unit and probe obtained in 2000. For two years running, Osler hosted a Canada-wide conference with international leaders in those field and, in 2010, sent an interdepartmental group of Osler ED, Critical Care, Respirology and Anesthesia staff to France to train under world Lung and Critical Care POCUS expert, Dr. Daniel Lichtenstein.

Since then, Dr. Lichtenstein has returned to Osler every two years to train more than 50 Osler ED and Critical staff in his holistic POCUS approach. The most recent training session was held this month at Brampton Civic and also included Internal Medicine, Palliative Care, Critical Care Nursing and Emergency Medical Service staff, as well as some medical residents.

“Hundreds of Osler patients have already benefited from the high level of POCUS training at Osler,” said Dr. Handler. “POCUS is akin to learning a new language,” he added. “With time and effort it is advancing patient care via integration into important accurate safe clinical care pathways, much as the stethoscope did several hundred years ago.”