Purpose This study aims to investigate the effects of point-of-care ultrasound (PoCUS) on length of stay (LOS) and mortality in hemodynamically stable patients with chest pain/dyspnea. Materials and Methods The prospective study was conducted from June 2020 to May 2021. A convenience sample of adult non-traumatic patients with chest pain/dyspnea was included and evaluated by PoCUS. The primary outcome was the relationship between the door-to-PoCUS time and LOS/mortality categorized by the ST-segment elevation (STE) and non-STE on the initial electrocardiogram. The diagnostic accuracy of PoCUS was computed, compared to the final diagnosis. Results A total of 465 patients were included. 3 of 18 patients with STE had unexpected cardiac tamponade and 1 had myocarditis with pulmonary edema. PoCUS had a minimal effect on LOS and mortality in patients with STE. In the non-STE group, the shorter door-to-PoCUS time was associated with a shorter LOS (coefficient, 1.26±0.47, p=0.008). After categorizing the timing of PoCUS as 30, 60, 90, and 120 minutes, PoCUS had a positive effect, especially when performed within 90 minutes of arrival, on LOS of less than 360 minutes (OR, 2.42, 95% CI, 1.61–3.64) and patient survival (OR, 3.32, 95% CI, 1.14–9.71). The overall diagnostic performance of PoCUS was 96.6% (95% CI, 94.9–98.2%), but lower efficacy occurred in pulmonary embolism and myocardial infarction. Conclusion The use of PoCUS was associated with a shorter LOS and less mortality in patients with non-STE, especially when performed within 90 minutes of arrival. Although the effect on patients with STE was minimal, PoCUS played a role in discovering unexpected diagnoses.
Background:Bladder stones are common diseases, constituting 5% of urinary stones. However, iatrogenic bladder rupture with intraperitoneal bladder stones is a rare complication after a transurethral cystolithotripsy (TUCL).Case presentation:A 73-year-old male was sent to the emergency department (ED) with presentations of dyspnea and hematuria after receiving a transurethral cystolithotripsy(TUCL) with laser. Upon arrival, his vital signs were relatively stable. An abdominal X-ray showed a radiopaque lesion within the pelvis. Physical examinations showed diffuse abdominal tenderness with muscle guarding. The initial focused assessment of sonography for trauma (FAST) was positive. Computed tomography (CT) revealed bladder rupture with intraperitoneal bladder stones. The patient received conservative supportive care with antibiotics and foley drainage and was discharged 3 weeks later smoothly.Conclusion:For emergency physicians, bladder rupture should be taken into consideration in patients with intraperitoneal bladder stones following TUCL. Computed tomography remains a standard of diagnosis although ultrasonography is a convenient screening tool for ascites.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.