A Shifting Paradigm – The Role of Focused Cardiac Ultrasound in Bedside Patient Assessment.
Transthoracic echocardiography is the standard of care in anatomic and functional cardiovascular assessment; however, Focused Cardiac Ultrasound (FoCUS) performed with portable ultrasound equipment is increasingly being used as an adjunct to comprehensive history and physical examination. FoCUS assessments, unlike formal echocardiography, are intended to assist physicians in answering explicit clinical questions with a narrow differential diagnosis in real-time. Over the past decade a growing body of literature has repeatedly demonstrated the value that FoCUS adds to clinical evaluation. Specifically, FoCUS improves point-of-care diagnostic accuracy, which in turn modifies treatment plans, decreases time to diagnosis, and reduces resource utilization. Though less robust, there is also evidence demonstrating improvement in clinical outcomes. Based on this evidence, clinicians, training programs, and clinical societies have embraced FoCUS as a tool to complement bedside patient evaluation. Herein, we review the evidence for FoCUS in clinical practice, specifically evaluating the diagnostic accuracy, the impact on clinical decision making, and the effect on clinical outcomes.