Patient-performed point-of-care ultrasound (POCUS) may be feasible for use in home-based healthcare. We investigated whether novice users can obtain lung ultrasound (LUS) images via self-scanning with similar interpretability and quality as experts. Adult participants with no prior medical or POCUS training, who were capable of viewing PowerPoint slides in their home and who could hold a probe to their chest were recruited. After training, volunteers self-performed 8-zone LUS and saved images using a hand-held POCUS device in their own home. Each 8-zone LUS scan was repeated by POCUS experts. Clips were independently viewed and scored by POCUS experts blinded to performing sonographers. Quality and interpretability scores of novice- and expert-obtained LUS images were compared. Thirty volunteers with average age of 42.8 years (Standard Deviation (SD) 15.8), and average body mass index of 23.7 (SD 3.1) were recruited. Quality of novice and expert scans did not differ (median score 2.6, interquartile range (IQR) 2.3–2.9 vs. 2.8, IQR 2.3–3.0, respectively p = 0.09). Individual zone quality also did not differ (P > 0.05). Interpretability of LUS was similar between expert and novice scanners (median 7 zones interpretable, IQR 6–8, for both groups, p = 0.42). Interpretability of novice-obtained scans did not differ from expert scans (median 7 out of 8 zones, IQR 6–8, p = 0.42). Novice-users can self-obtain interpretable, expert-quality LUS clips with minimal training. Patient-performed LUS may be feasible for outpatient home monitoring.
Funding and support: By JACEP Open policy, all authors are required to disclose any and all commercial, financial, and other relationships in any way related to the subject of this article as per ICMJE conflict of interest guidelines (see www.icmje.org). The authors have stated that no such relationships exist.
Study Objectives: Race and sex disparities in health care have been previously documented in the literature. A contributing factor may be "unconscious bias"-the concept that patients may be treated differently due to social stereotypes a provider is unaware they are acting upon. This effect may be more pronounced in busy and stressful environments such as the emergency department. Socioeconomic status and other social determinants of health likely also contribute to disparities in care. Our study objective was to describe patterns in emergency care surrounding race and sex demographics. Subjective measurements included patient satisfaction surveys rating provider empathy and quality of visit. Objective measurements included admission rates and length of stay (LOS). Methods: A descriptive secondary analysis of prospective data collected at a tertiary academic level 1 trauma center emergency department was performed from July to August 2018. All comers were included. A non-physician research assistant asked the patient or family member to complete a survey rating physicians on courtesy, listening, concern for comfort, informed on care, treatment of pain, time waiting, and overall visit. Patient demographics, length of stay, and patient disposition were recorded. Results: 204 patients responded overall. Median satisfaction scores in nearly all categories ranged from 4 (good) to 5 (very good). Median White LOS was 192 minutes vs non-white LOS of 185.5 minutes, Black LOS was 207 minutes. White discharge rate was 47.9% vs 75.6% non-White overall, Black discharge rate was 80%, and Hispanic discharge rate was 74.1%. Male discharge rate was 60.7% vs 58.3% female. Complete Median LOS and % admission rate by race and sex are reported in Table 1. Conclusion: Patient satisfaction scores were comparable across both race and sex. Median LOS and discharge rate by sex was comparable. LOS for Black demographic patients was 15 minutes longer than White patients and 21.5 minutes longer than non-White patients. This may be meaningful particularly given a high discharge rate of 80% for Black patients. Non-White patients overall had a much higher discharge rate from the emergency department compared to White patients. Possible factors for this large difference include lack of insurance, access to primary care, health literacy, and Female (n ¼ 115) 193 (0-582) Discharged: 67 (58.3%) Admit Floor: 48 (41.7%) Volume 76, no. 4s : October 2020 Annals of Emergency Medicine S59 Research Forum Abstracts Conclusion: Given comparable findings in the presence and distribution of abnormalities between POCUS and chest CT, POCUS may be a viable alternative to chest CT for diagnosis and risk stratification in patients with suspected COVID-19.
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