Rules of GIMUS

Ultrasound is a valuable tool in general internal medicine and can be used to address and/or manage an array of conditions. In the following section, we will highlight some key principles to consider when using this technology in the clinical environment:

  • Bedside ultrasound is an adjunct to the clinical examination, it does not supplant the need for comprehensive or confirmatory diagnostic testing.
  • It is important to communicate to patients and families how your are applying this tool including to expedite a potential intervention or provide insight while the patient awaits further confirmatory testing. It is often helpful to highlight that your study may not supplant the need to perform an additional test.
  • Prior to independently performing an ultrasound-guided procedure, you will need to demonstrate your skill to an experienced provider.
  • You will need to continually develop your skills through residency and into practice, as like any other specialized skill.
  • Communication is essential, understand that it is much more powerful to communicate sonographic findings in the context of the patient, rather than in isolation (i.e. B-lines in hypertensive patient with SOB vs B-lines in healthy young female patient with cholecystitis).
  • Always triangulate findings to clinical context and to previous imaging tests (i.e. if patient had prior abdominal US identifying ascites, it is very likely they have ascites).