It’s a Friday afternoon at The University of New Mexico Hospital, and David Stromberg, MD, associate professor at UNM’s Department of Family & Community Medicine, lies on a table in a pair of black and yellow running shorts.
There, four UNM School of Medicine residents take turns using advanced ultrasound technology on Stromberg’s left leg. In this practice exam, the students are looking for evidence of deep vein thrombosis.
As the transducer travels down the vessels, the onscreen image – a bed of deep blacks and understated whites – lights up with red and blue splotches. The images, which can help doctors diagnose critical diagnoses at the bedside, dance on the screen, all in real time.
Whether it’s a rotator cuff injury or a screening for an abdominal aortic aneurysm, up-and-coming ultrasound technology can diagnose critical care ailments on the spot, unlike an X-ray or CT scan. And some of these exams can take place in your family medicine clinic.
“It can be 30 seconds and it’s real-time, too, which is the other cool thing,” Stromberg says. “When you get out an ultrasound and you say, ‘This is the problem that I see,’ and you show that to a patient, it’s amazing. The patient can see it. I can see it, too. I think there’s a certain amount of camaraderie that you can build, but also a certain amount of confidence in the patient interaction, where you can have this imaging modality that’s real time.”
“It can be used on the entire body for certain things, anything from your eyeball to your foot,” Stromberg says. “If you have a specific clinical question, it can oftentimes be answered with an ultrasound.”
Instrumental for Rural Medicine
The technology also works in rural and underserved communities, because “all you need is an ultrasound machine and electricity,” Stromberg says. “There are handheld machines now.”
“You’re seeing a ton of [point-of-care ultrasounds] in terms of global health, but if you have these skills as a family doctor in rural New Mexico, you can potentially prevent hospitalization,” he says. “You can definitely diagnose someone and redirect their care in a way that would be much cheaper and way faster for the patient.”
The results speak for themselves. Stromberg explains that earlier this year, a patient’s vital signs had hospital staff worried that there was fluid around the heart. It was a Sunday, so the ultrasound techs weren’t readily available to perform an ultrasound.
“We did a point-of-care ultrasound and indeed thought we saw fluid around the heart,” Stromberg says. “We called the cardiologist and within about a half-hour, they had put in a needle and drained a fluid collection around the heart. We made the diagnosis, rather than calling the cardiologist and waiting for them to evaluate. I think it would have been several hours longer. It could’ve killed the patient.”
This is just the beginning for the technology, says Stromberg, who predicts that it will become a standard tool for doctors, especially in family medicine.
“If you think about it, the stethoscope was developed in 1816 and we’re still using it,” Stromberg says. “In some ways, this is supplanting the stethoscope.”