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Sun H, Wu A, Lu M, Cao S. Liability, risks, and recommendations for ultrasound use in the diagnosis of obstetrics diseases. Heliyon 2023; 9:e21829. [PMID: 38045126 PMCID: PMC10692788 DOI: 10.1016/j.heliyon.2023.e21829] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2023] [Revised: 10/27/2023] [Accepted: 10/30/2023] [Indexed: 12/05/2023] Open
Abstract
This literature review will summarize the liability issues, risks, and ultrasound recommendations for diagnosing obstetrics diseases. One liability issue is related to misdiagnosis or failure to detect abnormalities during an ultrasound examination. Ultrasound images can be subjective interpretations, and errors may occur due to factors such as operator skill, equipment limitations, or fetal positioning. Another liability concern is related to the potential adverse effects of ultrasound exposure on both the mother and fetus. While extensive research has shown that diagnostic ultrasound is generally safe when used appropriately, there are still uncertainties regarding long-term effects. Some studies suggest a possible association between prolonged or excessive exposure to ultrasound waves and adverse outcomes such as low birth weight, developmental delays, or hearing impairment. Additionally, obtaining informed consent from patients is crucial in mitigating liability risks. Patients should be informed about the purpose of the ultrasound examination, its benefits, limitations, potential risks (even if minimal), and any alternative diagnostic options available. This ensures that patients know the procedure and can make informed decisions about their healthcare. Proper documentation helps establish a clear record of the care provided and can serve as evidence in any legal disputes.
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Affiliation(s)
- Haiting Sun
- Department of Ultrasound, The Affiliated Xiangshan Hospital of Wenzhou Medical University, Ningbo, 315700, Zhejiang Province, PR China
| | - An Wu
- Department of Ultrasound, The Affiliated Xiangshan Hospital of Wenzhou Medical University, Ningbo, 315700, Zhejiang Province, PR China
| | - Minli Lu
- Department of Ultrasound, The Affiliated Xiangshan Hospital of Wenzhou Medical University, Ningbo, 315700, Zhejiang Province, PR China
| | - Shan Cao
- Department of Obstetrics, The Affiliated Second People's Hospital of Yuhang District, Hangzhou City, Hangzhou, 311100, Zhejiang Province, PR China
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Soni NJ, Schnobrich D, Mathews BK, Tierney DM, Jensen TP, Dancel R, Cho J, Dversdal RK, Mints G, Bhagra A, Reierson K, Kurian LM, Liu GY, Candotti C, Boesch B, LoPresti CM, Lenchus J, Wong T, Johnson G, Maw AM, Franco-Sadud R, Lucas BP. Point-of-Care Ultrasound for Hospitalists: A Position Statement of the Society of Hospital Medicine. J Hosp Med 2019; 14:E1-E6. [PMID: 30604779 PMCID: PMC8021128 DOI: 10.12788/jhm.3079] [Citation(s) in RCA: 77] [Impact Index Per Article: 15.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Many hospitalists incorporate point-of-care ultrasound (POCUS) into their daily practice to answer specific diagnostic questions or to guide performance of invasive bedside procedures. However, standards for hospitalists in POCUS training and assessment are not yet established. Most internal medicine residency training programs, the major pipeline for incoming hospitalists, have only recently begun to incorporate POCUS in their curricula. The purpose of this document is to inform a broad audience on what POCUS is and how hospitalists are using it. This document is intended to provide guidance for the hospitalists who use POCUS and administrators who oversee its use. We discuss POCUS 1) applications, 2) training, 3) assessments, and 4) program management. Practicing hospitalists must continue to collaborate with their local credentialing bodies to outline requirements for POCUS use. Hospitalists should be integrally involved in decision-making processes surrounding POCUS program management.
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Affiliation(s)
- Nilam J Soni
- Division of General and Hospital Medicine, The University of Texas Health San Antonio, San Antonio, Texas, USA.
- Section of Hospital Medicine, South Texas Veterans Health Care System, San Antonio, Texas, USA
| | - Daniel Schnobrich
- Divisions of General Internal Medicine and Hospital Pediatrics, University of Minnesota, Minneapolis, Minnesota, USA
| | - Benji K Mathews
- Department of Hospital Medicine, HealthPartners Medical Group, Regions Hospital, St. Paul, Minnesota, USA
| | - David M Tierney
- Department of Medical Education, Abbott Northwestern Hospital, Minneapolis, Minnesota, USA
| | - Trevor P Jensen
- Division of Hospital Medicine, Department of Medicine, University of California San Francisco, San Francisco, California, USA
| | - Ria Dancel
- Division of Hospital Medicine, Department of Medicine, University of North Carolina, Chapel Hill, North Carolina, USA
- Division of General Pediatrics and Adolescent Medicine, Department of Pediatrics, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Joel Cho
- Department of Hospital Medicine, Kaiser Permanente San Francisco Medical Center, San Francisco, California; USA
| | - Renee K Dversdal
- Division of Hospital Medicine, Oregon Health and Science University, Portland, Oregon, USA
| | - Gregory Mints
- Division of Hospital Medicine, Weill Cornell Medicine, New York, New York, USA
| | - Anjali Bhagra
- Division of General Internal Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Kreegan Reierson
- Department of Hospital Medicine, HealthPartners Medical Group, Regions Hospital, St. Paul, Minnesota, USA
| | - Linda M Kurian
- Division of Hospital Medicine, Zucker School of Medicine at Hofstra Northwell, New Hyde Park, New York, USA
| | - Gigi Y Liu
- Hospitalist Program, Division of General Internal Medicine, Department of Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Carolina Candotti
- Division of Hospital Medicine, University of California Davis, Davis, California, USA
| | - Brandon Boesch
- Division of Hospital Medicine, Alameda Health System-Highland Hospital, Oakland, California, USA
| | - Charles M LoPresti
- Louis Stokes Cleveland Veterans Affairs Hospital, Cleveland, Ohio, USA
- Case Western Reserve University School of Medicine, Cleveland, Ohio, USA
| | - Joshua Lenchus
- Division of Hospital Medicine, University of Miami, Miami, Florida, USA
| | - Tanping Wong
- Division of Hospital Medicine, Weill Cornell Medicine, New York, New York, USA
| | - Gordon Johnson
- Division of Hospital Medicine, Legacy Healthcare System, Portland, Oregon, USA
| | - Anna M Maw
- Division of Hospital Medicine, University of Colorado, Aurora, Colorado, USA
| | | | - Brian P Lucas
- White River Junction VA Medical Center, White River Junction, Vermont, USA
- Geisel School of Medicine at Dartmouth College, Hanover, New Hampshire, USA
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Gray K, Korn A, Zane J, Gonzalez G, Kaji A, Bowens N, de Virgilio C. Ultrasound Vein and Artery Mapping by General Surgery Residents During Initial Consult Can Decrease Time to Dialysis Access Creation. Ann Vasc Surg 2018; 49:285-288. [PMID: 29477677 DOI: 10.1016/j.avsg.2018.02.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2017] [Revised: 02/06/2018] [Accepted: 02/12/2018] [Indexed: 10/17/2022]
Abstract
BACKGROUND Formal preoperative ultrasound (US) mapping of vascular anatomy by radiology is recommended before hemodialysis access surgery. We hypothesized that US performed by general surgery residents in place of formal US would decrease the time from initial consult to creation of dialysis access without affecting patient outcomes. METHODS This is a retrospective review of all patients who underwent dialysis access surgery from November 2014 to July 2016 and received preoperative upper extremity US vein and artery evaluation by either radiology or general surgery residents. The primary endpoints were days from initial consult to dialysis access creation, rate of arteriovenous fistula (AVF) creation, fistula maturation, and 1-year primary assisted patency. RESULTS Of 242 patients, 167 (69%) had formal US, and 75 (31%) had only a resident US. The resident US group had 100% AVF creation compared with the formal US group with 92.2% AVF creation (P = 0.01). There was no difference between the groups in rate of fistula maturation (P = 0.1) and 1-year assisted patency (P = 0.9). Of the resident US 90.7% occurred in the outpatient setting. On multivariable analysis controlling for outpatient consult, the average time to the operating room was 13.7 days longer for the formal US group in the outpatient setting (P = 0.0006). CONCLUSIONS Ultrasound vein and artery evaluation at the time of the initial consult by general surgery residents can decrease the time to dialysis access creation by bypassing the need for formal US with a higher rate of AVF creation and no difference in fistula maturation or 1-year primary assisted patency.
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Affiliation(s)
- Kelsey Gray
- Department of Surgery, Harbor UCLA Medical Center, Torrance, CA
| | - Abraham Korn
- Department of Surgery, Harbor UCLA Medical Center, Torrance, CA
| | - Joshua Zane
- Department of Surgery, Harbor UCLA Medical Center, Torrance, CA
| | | | - Amy Kaji
- Department of Emergency Medicine, Harbor UCLA Medical Center, Torrance, CA
| | - Nina Bowens
- Department of Surgery, Harbor UCLA Medical Center, Torrance, CA; Division of Vascular Surgery, Department of Surgery, Harbor UCLA Medical Center, Torrance, CA
| | - Christian de Virgilio
- Department of Surgery, Harbor UCLA Medical Center, Torrance, CA; Division of Vascular Surgery, Department of Surgery, Harbor UCLA Medical Center, Torrance, CA.
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