Added Diagnostic Value of Point of Care Ultrasound in Acute Dyspnea: a Prospective Observational Study
试验速览
- 阶段
- 不适用
- 状态
- 招募中
- 发起方
- Region Skane
- 入组人数
- 160
- 试验地点
- 2
- 主要终点
- Discharge diagnosis
研究概览
简要总结
Dyspnea is a common diagnostic challenge in the Emergency Department (ED). Delay in diagnosis will increase time to correct treatment and could impact outcome. Previous studies have shown excellent diagnostic performance of point of care ultrasound (POCUS) to detect and differentiate between several important diagnosis (e.g heart failure and pneumonia) in patients with dyspnea. However, in most studies POCUS is performed by physicians highly experienced in ultrasound and often studies have focused only on one or few diagnoses. The aim of this study is to compare the diagnostic accuracy of different diagnosis in dyspnoeic patients before and after a ED physician with limited training applies POCUS.
详细描述
Dyspnoea is a common presenting complaint in the Emergency Department (ED). Dyspnoea requires timely evaluation and treatment as several conditions causing dyspnea are time critical.
Previous studies have suggested that point-of-care ultrasound (POCUS) increase diagnostic accuracy in the initial assessment of patients with dyspnoea. However, in most studies POCUS was done by highly experienced physicians which could limit the generalisability of POCUS in the hands of all emergency specialist and residents.
Aim To evaluate whether POCUS performed by a variety of emergency medicine physicians (specialists and residents) increase diagnostic accuracy in patients with dyspnea compared to routine assessment.
Method:
Specialist and residents in Emergency Medicine at the ED in Lund and Helsingborg (Sweden) will have a short training and certification in a structured dyspnea POCUS protocol. The protocol includes focused lung (8 or 14 zones), heart (subcostal, parasternal and apical four chamber views) and inferior vena cava ultrasound.
研究设计
- 研究类型
- Observational
- 观察模型
- Cohort
- 时间视角
- Prospective
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Adult patients presenting to the Emergency Department within the highest or second highest triage category and any of the following
- •Presenting with shortness of breath
- •Oxygen saturation less than 90 % on room air
- •Respiratory rate more than 25 breaths per minute and oxygen saturation less than 95 % on room air
排除标准
- •Inclusion in the study will delay urgent interventions
- •Patient is discharge from the Emergency Department (without hospital admission)
结局指标
主要结局
Discharge diagnosis
时间窗: Final diagnosis at index visit discharge
Any of the following diagnosis: Decompensated heart failure, pulmonary embolism, COPD exacerbation, asthma exacerbation, bacterial pneumonia, viral pneumonia, pleural fluid, pericardial fluid
次要结局
未报告次要终点