The evolution of ultrasound: A full circle event
October is Medical Ultrasound Awareness month! Since it first came into use, ultrasound has evolved and now is an integral part of patient care.
Ultrasound utilization began with sonar on ships during World War II, but it quickly gained interest among physicians for its body imaging capabilities in cardiac and obstetrics specialties. As the knowledge of ultrasound physics evolved, so did the technology, requiring the development of specific expertise for machine operation and image acquisition.
The current model seen in diagnostic imaging involves specially trained and registered sonographers who perform full diagnostic ultrasounds at the request of physicians and a radiologist who interprets the images and sends that information back to the physician for management. With the advent of user-friendly technology in pocket-sized machines, an ultrasound can be done literally everywhere – including space!
Today, you’ll hear different descriptors in connection with the term ultrasound. The terms “diagnostic” and “medical” typically evoke the traditional process of physician order, sonographer performed, radiologist read. Emergency physicians began using ultrasound in the care of critically ill and injured patients in the 1980s, leading to the term emergency ultrasound. Over time, there have been many terms describing ultrasound performed outside of diagnostic imaging; physician-performed ultrasound, bedside ultrasound and point-of-care ultrasound (POCUS), to name a few. While they can be used interchangeably, all intend to describe ultrasound used by the physician at the bedside to answer goal-directed questions.
The use of ultrasound has continued to permeate through medicine and now dozens of subspecialties have incorporated this technology into patient care. New terms are entering the ultrasound model to classify uses further, including “specialty specific,” “procedural” or “ultrasound guided” and “clinical ultrasound.” All ultrasound is ultrasound, but whether it is performed by a specially trained technologist and interpreted by a physician (radiology, cardiology and obstetric model) or if it is performed and interpreted by the same clinician, it has implications for patient care.
Ultrasound has come full circle – from being invented and used by physicians as part of their clinical practice to answer clinical questions to being specialized and developed into a diagnostic imaging system, to transitioning back to the hands of physicians to answer clinical questions. New opportunities for collaboration and consensus emerge, such as deciding what names should be assigned to the defined practice, documentation, and billing as ultrasound becomes more commonly practiced outside diagnostic imaging.
Learn more about POCUS.
By Cherie Tator MS, RDMS (ABD, OB/GYN, BR, PS) RVT, POCUS instructor and associate thread director of POCUS with the School of Medicine at Baylor College of Medicine, and Dr. Kiyetta Alade, associate professor and POCUS thread director with the School of Medicine at Baylor College of Medicine
