Impact of Immediate Point-of-Care Ultrasound on Patients With Cardiopulmonary Symptoms in the Emergency Department
Overview
- Phase
- Not Applicable
- Intervention
- Not specified
- Conditions
- Chest Pain
- Sponsor
- Yale University
- Enrollment
- 170
- Locations
- 1
- Primary Endpoint
- Time to appropriate intervention
- Status
- Completed
- Last Updated
- 6 years ago
Overview
Brief Summary
The purpose of the proposed research is to examine whether incorporating point-of-care ultrasound (POCUS) early in diagnostic work-up of cardiopulmonary complaints will affect diagnosis, time to condition-specific intervention, and ultimately patient outcomes compared to usual care.
Investigators
Eligibility Criteria
Inclusion Criteria
- •Chief complaint of chest pain, dyspnea (either sudden onset or increased severity of chronic dyspnea), syncope, or hypotension (systolic blood pressure \<100 or shock index \[heart rate divided by systolic blood pressure\] \>1)
Exclusion Criteria
- •\<18 years old
- •Prisoner or ward of the state
- •High acuity requiring treatment in resuscitation room
- •Obvious cause of symptoms (e.g. acute GI bleed causing hypotension)
- •Any form of "do not resuscitate" (DNR) order
- •Roomed in hall of emergency department (location not amenable to ultrasound protocol)
Outcomes
Primary Outcomes
Time to appropriate intervention
Time Frame: Within 30 days of presentation
Based on final diagnosis as determined by final review of the patient's overall visit in the medical record, it will be determined what the appropriate intervention(s) that the patient should have received. Subsequently, the amount of time that elapsed (minutes) between time the patient was roomed in the emergency department (ED) and time to when they received the intervention will be collected. All these time points are readily available in the electronic medical record in the patient care timeline. This outcome will help determine whether early POCUS affects how quickly patients receive appropriate intervention.
Secondary Outcomes
- Diagnostic accuracy(Within 30 days of presentation)
- Total length of stay(Within 30 days of presentation)
- Duration of POCUS(Within 2 days of presentation)
- Diagnostic certainty(Within 2 days of presentation)
- Time to disposition(Within 2 days of presentation)
- 30-day in-hospital mortality(Within 30 days of presentation)