Table 1
Insonation is applicable to most medical specialties.
| Specialty | Point of Care Insonation |
|---|---|
| Anesthesia | Guidance for vascular access, regional anesthesia, intraoperative monitoring of fluid status and cardiac function |
| Cardiology | Echocardiography, intracardiac assessment |
| Critical care medicine | Procedural guidance, pulmonary assessment, focused echocardiography, hypotension evaluation |
| Dermatology | Assessment of skin lesions and tumors |
| Emergency medicine | Trauma assessment, hypotension evaluation, evaluation of ectopic pregnancy, procedural guidance |
| Endocrinology and endocrine surgery | Assessment of thyroid and parathyroid, procedural guidance |
| General surgery | Ultrasonography of the breast, procedural guidance, intraoperative assessment |
| Gynecology | Assessment of cervix, uterus, and adnexa; procedural guidance |
| Neonatology | Cranial and pulmonary assessments |
| Nephrology | Vascular access for dialysis |
| Neurology | Transcranial Doppler, peripheral-nerve evaluation |
| Obstetrics and maternal–fetal medicine | Assessment of pregnancy, detection of fetal abnormalities, procedural guidance |
| Ophthalmology | Corneal and retinal assessment |
| Orthopedic surgery | Musculoskeletal applications |
| Otolaryngology | Assessment of thyroid, parathyroid, and neck masses; procedural guidance |
| Pathology | Guidance for fine needle aspiration, biopsy |
| Pediatrics | Assessment of bladder, procedural guidance |
| Physical and rehabilitation medicine | Musculoskeletal diagnostic applications, procedure guidance |
| Pulmonary medicine | Transthoracic pulmonary assessment, endobronchial assessment, procedural guidance |
| Radiology and interventional radiology | Ultrasonography taken to the patient with interpretation at the bedside, procedural guidance |
[i] Adapted from Moore, NEJM 2011.
Table 2
Sample Longitudinal Insonation Curriculum.
| Year | Complementary coursework | Sample Topics |
|---|---|---|
| Year 1 | Anatomy, physiology | Ultrasound anatomy of cardiovascular system, hepatobiliary system, kidneys, bladder, etc. Dynamic anatomy of heart (cardiac contractility, valve motion), lungs (pleural sliding, diaphragm movement), musculoskeletal system (tendon, join movement, muscular contraction), etc. |
| Year 2 | Pathophysiology, Physical Examination course | Correlation of physical examination and landmark anatomy to ultrasound findings. Cardiac function and relation to hemodynamic assessments such as stroke volume, cardiac output, Starling curve, etc. |
| Years 3–4 | Specialty Rotations | Core topics based on specialty, such as fetal assessments in OB, cardiovascular assessments, bladder volume in Internal Medicine, Thoracic ultrasound in Intensive Care Medicine, Hepatobiliary assessments in Emergency Medicine and Surgery, etc. |