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by Nikhil Jaganathan
From targeted vascular access to cardiac imaging, point-of-care ultrasound (POCUS) has become an essential extension of an anesthesiologist’s diagnostic and interventional toolkit and a critical skill for future physicians to master. At my medical college, students receive ultrasound education from the first month of preclerkship, learning the basics of probe positioning and vessel visualization. Over the subsequent weeks, students receive monthly instruction on musculoskeletal imaging, cardiac ultrasound, abdominal imaging, and ultimately a full Focused Assessment with Sonography for Trauma (FAST) exam and Rapid Ultrasound for Shock and Hypotension (POCUS) exam by the end of preclerkship. As students develop these imaging skills, they are placed in immersive clinical simulations where they utilize ultrasound to guide their differential diagnosis and therapeutic plan in order to apply these skills to patient care. From scenarios assessing hypovolemic shock, ruptured ectopic pregnancies, and cardiac failure to hands-on practice with ultrasound-guided needle placement, students at my school receive longitudinal ultrasound training to apply during clerkships. Subsequently, whether completing preventive abdominal aorta screens during family medicine, ascertaining fetal position and heart rate in OBGYN, or assessing for gallstones in surgery rotations, students then apply their ultrasound knowledge in numerous ways to complete various requirements during core rotations. Students also receive the opportunity to participate in ultrasound electives to cultivate their skills in ultrasound interpretation and clinical skills. Various organizations within my medical college, such as Ultrasound Interest Group, aim to engage students with ultrasound technology early in their medical careers through additional workshops and guest speakers from leaders in the field to discuss sonographic applications across various specialties. My medical college is just one of many institutions embracing the growing role of ultrasound in patient care, reflecting a broader trend in medical education to equip students with current, technology-driven procedural techniques.
Ultrasound plays a critical role in the field of anesthesiology through each stage of perioperative care. In the preoperative setting, POCUS can be utilized for endotracheal tube placement, visualization of airway structures, and regional anesthesia in airway management (1). Additionally, gastric ultrasound can evaluate stomach contents and aspiration risk peroperatively (2). POCUS is also critical for cardiac (transthoracic echocardiography), lung (especially in evaluating for impaired diaphragmatic function, pneumothorax, pleural effusion, or pulmonary edema), and abdominopelvic assessment to evaluate for procedural risk (1, 2). Trauma can be identified using the FAST exam which allows for identification of free abdominal or thoracic fluid (2). POCUS is also critical for hemodynamic monitoring, volume status (especially through inferior vena cava and cardiac ultrasound), and vascular access preoperative and intraoperatively (2, 3). POCUS is routinely used for targeted nerve blocks in regional anesthesia, such as brachial plexus blocks, as well as in spinal visualization for epidural injections in obstetric anesthesia, to improve patient safety (2). POCUS can also enhance timely diagnosis of postoperative complications ranging from pericardial effusion to pneumothorax. In essence, POCUS plays a multifaceted role in anesthesia in facilitating rapid diagnosis and improved patient outcomes.
As ultrasound grows in prevalence with its diverse multispecialty applications, there is a growing need for medical students, notably those pursuing anesthesia, to develop proficiency in this skill. While some schools have opportunities to learn ultrasound as a part of the medical school curriculum through electives and structured instructional sessions, the breadth of ultrasound technology often warrants further independent practice. Whether honing skills in ultrasound or anesthesia interest group workshops or practicing diagnostic sonography through online modules, various opportunities exist for extracurricular involvement. Moreover, seeking mentorship from ultrasound-trained residents or faculty during rotations or shadowing allows for real-time feedback and clinical implementation of learned skills. Ultimately, as future anesthesiologists, we must prioritize developing ultrasound proficiency to promote diagnostic efficacy, procedural precision, and patient safety across perioperative care.
References:
1. Gohad R, Jain S. The Use of Point-of-Care Ultrasound (POCUS) in Anesthesiology: A Narrative Review. Cureus. 16(9):e70039. doi:10.7759/cureus.70039
2. Arumugam S, Kolli S, Brakoniecki K, Singh PA, Kukreja P, Kalagara H. Point-of-care Ultrasound (POCUS) for the Regional Anesthesiologist. Curr Anesthesiol Rep. 2024;14(2):231-248. doi:10.1007/s40140-024-00622-3
3. Naji A, Chappidi M, Ahmed A, Monga A, Sanders J. Perioperative Point-of-Care Ultrasound Use by Anesthesiologists. Cureus. 13(5):e15217. doi:10.7759/cureus.15217
Date of last update: July 9, 2025
