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Observational Study
. 2018 Dec 27;18(1):60.
doi: 10.1186/s12873-018-0211-4.

Point-of-care ultrasound findings in unselected patients in an emergency department -results from a prospective observational trial

Jesper Weile  1   2 , Christian B Laursen  3   4 , Christian A Frederiksen  5 , Ole Graumann  4   6 , Erik Sloth  7 , Hans Kirkegaard  8
Affiliations
Observational Study

Point-of-care ultrasound findings in unselected patients in an emergency department -results from a prospective observational trial

Jesper Weile et al. BMC Emerg Med. .

Abstract

Background: Point-of-care ultrasound (POCUS) can improve patient management in the emergency department (ED). However, previous studies have focused only on selected groups of patients, such as trauma, shock, dyspnea, or critically ill patients, or patients with an already known diagnosis. Most patients seen in the ED do not match these criteria. We aim to present total prevalence of positive findings when basic POCUS is applied to the broad population of patients seen in an emergency department.

Methods: We conducted a single-center prospective explorative observational study of 405 unselected patients aged 18 years or over. A structured whole-body ultrasound examination was performed on all patients within 2 h of arrival to the ED. The ultrasound examination consisted of focused cardiac ultrasound, focused abdominal ultrasound, focused assessment with sonography for trauma (FAST), and focused lung ultrasound.

Results: We managed to perform 94.5% of all planned examinations. The study revealed positive findings in 39.3% of all included patients. This study presents the prevalence of positive findings among subgroups of patients. Divided among the categories of chief complaint, we found 62 positive examinations in 58 (14.3%; 95% CI, 10.9-17.7) unique patients with orthopedic complaints, 77 positive examinations among 59 (14.6%; 95% CI, 11.1-18.0) unique patients with medical complaints, and 55 positive examinations among 42 (10.4%; 95% CI, 7.4-13.3) unique patients with abdominal surgical complaints.

Conclusion: POCUS revealed positive findings in more than one third of unselected patients in the emergency department. The study presents the findings and distribution among categories of chief complaints. Future investigations are necessary to elucidate the implication of the findings.

Keywords: Emergency medicine; Point-of-care ultrasound; Prevalence.

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Conflict of interest statement

Ethics approval and consent to participate

This study complies with the Declaration of Helsinki. The British Medical Ultrasound Society (BMUS) has published guidelines for the safety of diagnostic ultrasound, which were strictly followed in this study [40]. All participating patients gave informed written consent to participate. In the event that the participant could not give informed consent, written consent was obtained from the patient’s next of kin and primary care physician subsequent to enrollment. No patients involved in the study received a lower level of care than if they were not included. All clinical workups and choices of medical intervention were administered under the liability of the treating physician. The study complies with the STROBE statement for cross sectional studies. The study was approved by the Danish National Ethics Committee (case no. 1305018) and registered with the Danish Data Protection Agency (ref. 1–16–02-603-14).

Consent for publication

Not applicable.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
All Performed Ultrasound Windows and the Positive Findings Evaluated during the Study
Fig. 2
Fig. 2
Trial Profile
See this image and copyright information in PMC

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