Bedside Diagnosis in the ICU: Is Looking Overlooked?
Ann Am Thorac Soc. 2015 Aug 4;
Authors: Metkus TS, Kim BS
Abstract
Bedside diagnosis, including but not limited to the physical examination, can be lifesaving in the setting of critical illness and is a core competency in both medical school and at the post-graduate level. Data as to the clinical utility of bedside diagnosis in the modern ICU is sparse, however, and there are no clinical guidelines addressing performance, interpretation, and utility of the bedside assessment in critically ill patients. Bedside assessment and physical examination are used in a heterogeneous manner across institutions and even across ICUs within the same institution, which has implications for medical education, patient care and the overuse-misuse of diagnostic testing. In this commentary, we review the existing data addressing bedside diagnosis in the ICU, describe different models of bedside assessment usage in the ICU based on our clinical practice and on the limited evidence base, share our practical "checklist-based" approach to bedside assessment in the critically ill patient, and advocate for more formal study of physical examination and bedside assessment in the ICU to enhance clinical practice.
PMID: 26389653 [PubMed - as supplied by publisher]