Could ultrasound replace the stethoscope?
Ultrasound can&#x27;t penetrate lungs (bags of gas) so probably not, you can see things like effusions, pneumothoraces, and maybe a peripheral consolidation.<p>Regardless, the stethoscope has (for better or worse) already been replaced for a while, at least for in-hospital care at larger US&#x2F;Canadian community&#x2F;academic settings, by chest x-ray and&#x2F;or the increasing straight jump to CT pulmonary angiography.<p>The amount of patients with respiratory complaints presenting acutely that leave hospital without radiology department imaging is probably &lt;10% today.<p>Physical exam skills as a whole are dying, abdominal pain is similarly a straight jump to CT or US these days, often before a physical exam is even documented (was it even done?). Even more true for gynaecological concerns (not debating whether or not this more ethical, but it&#x27;s very rare to see ER physicians perform a vaginal exam these days before ordering ultrasound).<p>In terms of the utility of POCUS, the heterogeneity in training has been a barrier to adoption by clinicians in Canada (I imagine similarly in the US). While POCUS is performed by ER&#x2F;internal medicine, patients are still being sent to radiology for formal imaging before definitive management takes place, even for more straightforward cases like gallstones and kidney stones. Presently, very few POCUS studies are formally uploaded to a patient&#x27;s record in my current hospital (largest institution in Canada) although that is increasing and clinician competence at POCUS is slowly rising.<p>The FAST exam in trauma settings is probably one of the only reliable POCUS uses at the moment, and echocardiography.