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About:
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Technological advancements have allowed more physicians to bring ultrasound services to the office visit or bedside, and to make POCUS an integral part of practice. I [Dr. Deutchman] was an early adopter, adding ultrasound to my rural practice in 1980 after delivering a surprise set of twins in the wee hours of the morning. I have never since been surprised by twins, nor missed an ectopic pregnancy. In addition, I [Dr. Shen-Wagner] first used POCUS during residency in 2011, after a patient complained that it felt like her intrauterine device (IUD) had moved. Everything looked normal on the pelvic exam, but a hand-me-down ultrasound machine from the clinic's obstetrics department revealed the unmistakable flutter of a tiny heartbeat. The patient was pregnant, despite having an IUD for three years.
These are just two examples of the many ways POCUS can benefit doctors and patients. There is robust evidence that POCUS improves care in critically ill patients and improves the efficiency and safety of many invasive ambulatory surgeries that are otherwise performed blindly or by anatomic landmarks. There is also preliminary but growing evidence that POCUS can improve diagnostic capabilities, expedite patient care, and inform bedside treatment and management. Most recently, POCUS has proven to be a valuable tool for confirming COVID-19 diagnoses, as well as monitoring some symptoms of the disease.
The hands-on, “showing while telling” nature of POCUS advances physical diagnosis skills, fosters doctor-patient communication, and increases patient satisfaction. This article outlines some common uses for POCUS and explains how to add it to a practice.
Electrocardiogram (ECG) Solutions
Electrocardiogram (ECG) systems record the electrical activity of the heart over time by measuring electric potentials on the surface of living tissue. A biopotential electrode is used to pick up heart signals from specific locations on the body. The differential voltage between two electrodes, or the differential voltage between one electrode and the average voltage of multiple electrodes, can be measured and displayed as one channel on the ECG printout.
The primary function of the AFE is to digitize the heart signals. This process is complicated by the need to reject interference from strong RF sources, pace signals, lead-off signals, common-mode frequency, signals from other muscles, and electrical noise. Typically, the AFE includes instrumentation amplifiers (INAs), filtering, and ADCs. There are two kinds of ECG architecture design approaches—ac coupling and dc coupling.
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