Abstract

Point of Care Ultrasound by Primary Care Physicians and Geriatricians: Old Adults, New Technology, Potential Benefits and Burdens

Sarah M. Schumacher, Andres F. Leone, Victor Rao, Duncan Howe, G.Paul Eleazer and Richard Hoppmann

Background/Objectives: Availability of economical, portable ultrasound systems that provide rapidly available, useful, information has transformed the clinical assessment of patients. As hand-held ultrasound systems become widely accessible, this technology will become standard of care in primary care practices. Little has been written about the use of ultrasound by Geriatricians, and the usefulness of POC-US specifically in caring for Older Adults.

Study design: In order to assess the current state of knowledge regarding use of ultrasound by geriatricians, and assess (POC-US) for the population of older adults, we conducted a review of published studies using Pub Med and Ovid search engines. Selected publications were included in a systematic review.

Results: Thirty-five articles were identified for systematic review. Eighteen articles addressed the use of ultrasound in the evaluation of Older Adult patients. Four articles that identified performance of ultrasound by Geriatricians, and an additional three articles were not clear the specialty performing the exam, but geriatricians used the information gained. A total of fifteen articles highlighted use by primary care physicians. Thirty-one articles identified the usefulness in specific diseases and conditions that are more common in older adults. Limitations and potential harm were identified in twelve articles.

Conclusion: There is very little literature on POC-US in Geriatrics, but existing literature highlights significant potential clinical use. POC-US holds great promise in primary care practices and in geriatrics. Our literature review found numerous potential uses for POC-US in caring for older adults. Few studies addressing the application of ultrasound in the geriatric population have been reported. The usefulness of POC-US by Geriatricians remains to be clarified. Judicious use of this technology in the geriatric population will be necessary to maximize the potential benefit while avoiding the potential harm of unnecessary tests, anxiety, and iatrogenic illness.