The death of the stethoscope
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Can ultrasound replace the stethoscope?
https://www.newyorker.com/science/annals-of-medicine/could-ultrasound-replace-the-stethoscope
The technology of ultrasound has been around a long time, but has been relegated, for the most part, to obstetrics and a few other specialties.
In the 5 years before I retired, we started to see ultrasound being used in more specialties, and now, US is becoming indispensable in anesthesiology.
I used to be pretty good at sticking a needle into the internal jugular vein. It was a knowledge of anatomy, persistence, and luck. If I had to guess, I was successful, on the first stick, about 85% of the time. It was a blind procedure, just stick it where you think the vein is.
Now, with ultrasound, you can stick it where you actually SEE the vein is. In fact, in some places, it has become standard of care to use US for IJ sticks. Woe unto you if you hit the carotid and cause a hemorrhage, or the lung and cause a collapse, and you weren't using US.
Similarly, nerve blocks have undergone a transformation. Knowing the anatomy of where certain nerve bundles are was crucial to being able to put a needle into the bundle and inject local anesthetic. As a resident, I was pretty good with these, but lack of practice made me rusty.
And now, as a former partner of mine said. talking about his younger colleagues, "Geez. Using ultrasound you wouldn't believe where these guys are putting needles."
As the article says, getting your first stethoscope as a student was quite the milestone. (Mine was a double-headed Littman). Now, you get an US probe. I'm such a dinosaur.
Brave new world.
-
Can ultrasound replace the stethoscope?
https://www.newyorker.com/science/annals-of-medicine/could-ultrasound-replace-the-stethoscope
The technology of ultrasound has been around a long time, but has been relegated, for the most part, to obstetrics and a few other specialties.
In the 5 years before I retired, we started to see ultrasound being used in more specialties, and now, US is becoming indispensable in anesthesiology.
I used to be pretty good at sticking a needle into the internal jugular vein. It was a knowledge of anatomy, persistence, and luck. If I had to guess, I was successful, on the first stick, about 85% of the time. It was a blind procedure, just stick it where you think the vein is.
Now, with ultrasound, you can stick it where you actually SEE the vein is. In fact, in some places, it has become standard of care to use US for IJ sticks. Woe unto you if you hit the carotid and cause a hemorrhage, or the lung and cause a collapse, and you weren't using US.
Similarly, nerve blocks have undergone a transformation. Knowing the anatomy of where certain nerve bundles are was crucial to being able to put a needle into the bundle and inject local anesthetic. As a resident, I was pretty good with these, but lack of practice made me rusty.
And now, as a former partner of mine said. talking about his younger colleagues, "Geez. Using ultrasound you wouldn't believe where these guys are putting needles."
As the article says, getting your first stethoscope as a student was quite the milestone. (Mine was a double-headed Littman). Now, you get an US probe. I'm such a dinosaur.
Brave new world.
@George-K said in The death of the stethoscope:
As the article says, getting your first stethoscope as a student was quite the milestone. (Mine was a double-headed Littman). Now, you get an US probe.
Imagine an engineer of old getting his first scientific calculator (probably with reverse Polish notation) … these days its just another app on his mobile phone.
But back to the stethoscope … not long ago I came across a high school science fair project where a student cut up a stethoscope, stick a microphone in it, sync the sound up to a phone app, which in turn uploads it to a cloud that (1) shares that recording with human physicians and (2) runs some AI model to diagnose heart conditions using the recorded sound.