The Use of a Point-of-care Thoracic Ultrasound Protocol for Hospital Medical Emergency Teams
Overview
- Phase
- N/A
- Intervention
- Not specified
- Conditions
- Dyspnea
- Sponsor
- Rijnstate Hospital
- Enrollment
- 100
- Locations
- 1
- Primary Endpoint
- Concordance between MET diagnosis with and without the use of ultrasound with the chart review definitive diagnosis will be studied
- Status
- Terminated
- Last Updated
- 5 years ago
Overview
Brief Summary
Study to assess the possible effects of the use of a point-of-care thoracic ultrasound protocol for hospital medical emergency teams (MET)
Detailed Description
Rationale: Study to assess the possible effects of the use of a point-of-care thoracic ultrasound protocol for hospital medical emergency teams Objective: Concordance between MET diagnosis with and without the use of ultrasound with the chart review definitive diagnosis will be studied. Also other secondary endpoints will be evaluated. Study design prospective, interventional study Study population: patients on the general wards in need treatment by the MET team Intervention (if applicable): When the MET team arrives first assessment will be done according to the abcde algorithm. If immediate interventions are needed (intubation, CPR etc) this will be done first (and noted). After the abcde assessment an initial diagnosis is noted. In the even weeks the thoracic ultrasound protocol will be done, in the uneven weeks not. After the use of ultrasound various variables are noted. Main study parameters/endpoints: Concordance between MET diagnosis with and without the use of ultrasound with the chart review definitive diagnosis will be studied. Also other secondary endpoints will be evaluated. Nature and extent of the burden and risks associated with participation, benefit and group relatedness: The use of ultrasound is without direct side effects in terms of radiation or other potential (non)physical disturbances. There are no data on the effects of the use of ultrasound during MET calls. The MET team will first deliver acute care if necessary, the ultrasound protocol can be done within 10-15 minutes which is acceptable in terms of MET call care. The MET team physician can at any point decide to use the ultrasound if he/she thinks it is necessary. In other circumstances (e.g. emergency department or intensive care units) point-of-care ultrasound is considered to be part of standard care. The investigators will study the potential influence of ultrasound during MET calls in terms of accuracy of the initial diagnosis and whether ultrasound influences initial treatment, patients' disposition and so on, ultrasound is no treatment nor will be the use of ultrasound be decisive in the treatment of MET call patients in this study.
Investigators
Eligibility Criteria
Inclusion Criteria
- •Adult patients on the general wards in need of treatment by the MET team.
Exclusion Criteria
- •age (\<18 years),
- •pregnancy:
Outcomes
Primary Outcomes
Concordance between MET diagnosis with and without the use of ultrasound with the chart review definitive diagnosis will be studied
Time Frame: after 2-3 weeks
final diagnosis will be determined by 2 independent experts on the basis of chart review and will be compared with the MET team diagnosis. There are 8 pre defined diagnosis categories. The difference in concordance between the MET diagnosis with and without the use of ultrasound with the definitive diagnosis will be tested with a chi-square or a Fisher Exact test in case of small expected frequencies.
Secondary Outcomes
- Possible difference in the need for supervisor attendance(direct after inclusion)
- Number of times ultrasound was used in te "non-ultrasound weeks"(direct after inclusion)
- Possible difference in the time needed to reach a diagnosis(direct after inclusion)
- Possible differences in patients' disposition(direct after inclusion)
- Possible difference in diagnostic certainty(direct after inclusion)
- Possible differences in initial treatment(direct after inclusion)
- Whether the use of ultrasound was considered to be helpful(direct after inclusion)
- MET physicians characteristics(direct after inclusion)