PEARLS for an Ultrasound Physical and Its Routine Use as Part of the Clinical Examination

Area of Science:

• Medical Education
• Diagnostic Imaging
• Clinical Skills Training

Background:

• Lack of standardized routine ultrasound (US) examination protocols.
• Point-of-care ultrasound (POCUS) is becoming a crucial clinical skill.
• Beginners find the wide range of POCUS applications overwhelming.

Purpose of the Study:

• To propose a structured mnemonic-based approach for routine physical examination augmented with POCUS.
• To provide a scalable framework for integrating POCUS into primary care and inpatient settings.
• To establish a foundation for developing POCUS skills for both novice and advanced users.

Main Methods:

• Introduction of the PEARLS (Parasternal, Epigastric, Anterior Lung, Right upper quadrant, Left upper quadrant, Suprapubic) mnemonic.
• Describing a core physical examination augmented with POCUS views.
• Framework designed for scalability for varying user expertise.

Main Results:

• The PEARLS mnemonic provides a systematic approach to POCUS for routine examinations.
• Overlapping views from existing trauma and critical care protocols are integrated.
• The approach is applicable beyond critically ill patients, suitable for generalists.

Conclusions:

• The PEARLS examination offers a standardized, scalable method for routine POCUS integration.
• This framework assists clinicians in building foundational POCUS skills.
• POCUS, guided by PEARLS, can be a valuable addition to the standard physical examination.