Do emergency physicians rely on point‐of‐care ultrasound for clinical decision making without additional confirmatory testing?

Moussa, Mohamad; Stausmire, Julie M.

doi:10.1002/jcu.22604

Cited by 7 publications

(7 citation statements)

References 10 publications

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“…The concept behind POCUS is to allow diagnosis at the patient bedside whether at the hospital, in an ambulance, or in the field. It has been shown to help emergency room physicians make fast and accurate decisions without needing to refer the patients to more complex imaging procedures [84], which may be particularly relevant during pandemics, such as the corona virus disease 2019 (COVID- 19) [85] although this is not always the case [86]. Because of its ever- Fig.…”

Section: Pocusmentioning

confidence: 99%

Obstetric ultrasound: where are we and where are we going?

Abramowicz

2021

Ultrasonography

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Ultrasonography. 2020 Aug 25. Epub ahead of print Diagnostic ultrasound (DUS) is, arguably, the most common technique used in obstetrical practice. From A mode, first described by Ian Donald for gynecology in the late 1950s, to B mode in the 1970s, real-time and gray-scale in the early 1980s, Doppler a little later, sophisticated color Doppler in the 1990s and three dimensional/four-dimensional ultrasound in the 2000s, DUS has not ceased to be closely associated with the practice of obstetrics. The latest innovation is the use of artificial intelligence which will, undoubtedly, take an increasing role in all aspects of our lives, including medicine and, specifically, obstetric ultrasound. In addition, in the future, new visualization methods may be developed, training methods expanded, and workflow and ergonomics improved.

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Section: Pocusmentioning

confidence: 99%

Obstetric ultrasound: where are we and where are we going?

Abramowicz

2021

Ultrasonography

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“…However, such high availability does not exist in emerging economies and developing countries. Even though FAST is frequently used, for example by 87.7 % of emergency physicians in the Ohio ACEP network, half of sonographers routinely proceed to an unnecessary CT examination of trauma patients [4].…”

Section: Dissemination and Trainingmentioning

confidence: 99%

“…Auch wenn FAST häufig eingesetzt wird, wie z. B. von 87,7 % der Notfallmediziner im OHIO-ACEP-Netzwerk, schließt die Hälfte der Sonografeure routinemäßig und wahrscheinlich häufig unnötigerweise eine CT-Untersuchung an [4].…”

Section: Verbreitung Und Ausbildungunclassified

New Perspectives for Modern Trauma Management – Lessons Learned from 25 Years FAST and 15 Years E-FAST

Österwalder¹,

Mathis²,

Hoffmann

2019

Ultraschall in Med

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E-FAST (Extended-Focused Assessment with Sonography for Trauma) is now a widely utilized and internationally recognized standard exam in trauma care. It is highly accepted by emergency physicians and trauma surgeons alike. Thanks to the popularity of PoCUS (point-of-care ultrasound), it has continued to evolve over the last years and can now improve trauma diagnosis at all stages of the primary ABCDE. This review article summarizes key observations made over recent years and also highlights the extension of FAST into E-FAST in the context of PoCUS and CT developments for modern trauma management. Time has come to learn the lessons from 25 years of FAST and 15 years of E-FAST. We should redefine and position ultrasound in the primary ATLS survey (Advanced Trauma Life Support) on two levels: 1. Basic ATLS with new clinical questions, six additional abdominal image sections and one or more follow-up examinations depending on the clinical situation, and 2. Advanced ATLS with ultrasound applications for the entire trauma ABCDE.

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“…This study was conducted to determine the usefulness of HHD as a triaging tool for acute testicular pain by ED physicians, and the results were compared with those of Doppler examinations performed by a radiologist [ 10 ]. The objective was not to use HHD as the sole diagnostic test or to circumvent the need for Doppler ultrasound performed by radiologists but rather to determine whether HHD can play a role in the ED to alleviate the burden on the radiology department.…”

Section: Introductionmentioning

confidence: 99%

Evaluating Acute Testicular Pain Using Point-of-Care Hand-Held Doppler in the Emergency Department: A Prospective Pilot Study

Hanumanthappa¹,

Naushad²,

Mohammed³

et al. 2021

Cureus

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IntroductionTesticular pain is one of the common conditions in patients visiting the emergency department. The causes of acute testicular pain vary from non-urgent inflammatory conditions like epididymo-orchitis to testicular torsion which is a surgical emergency. Early diagnosis of testicular torsion with early initiation of appropriate surgical intervention helps in salvaging the testes. There is a need for a simple, rapid bedside diagnostic tool for the evaluation and triaging of subjects with acute testicular pain in the emergency department. The aim of this study is to determine whether hand-held Doppler (HHD) examination by the emergency department (ED) physician can safely rule out testicular torsion in a case of acute testicular pain. Materials and MethodsA prospective pilot study was conducted in the emergency department of Alkhor Hospital, Hamad Medical Corporation, Qatar. The subjects between 18 to 50 years of age who presented to the ED with testicular pain were included. Subjects with recent trauma to the scrotum, or recent genitourinary surgery and those who had pain for more than 48 hours were excluded. Point-of-care HHD was done by a single ED physician who was blinded for the Doppler study results done by the radiologist. The results of the HHD performed by the ED physician and Doppler study performed by the radiologist were compared and analyzed. ResultsForty-five patients were included in the study. The mean age was 28 years and the mean duration of pain was 20 hours. HHD ruled out testicular torsion in 44 subjects with a specificity of 97.8%. In one subject, HHD was reported as torsion testis which was ruled out by the radiologist. The radiologist Doppler ruled out torsion in all 45 subjects. ConclusionThe diagnostic performance of HHD by the ED physicians was almost equal to that of radiologists in ruling out testicular torsion. HHD can be used as a first-line triaging tool by the ED physician to rule out torsion of testis in patients presenting with acute testicular pain. We conclude that patients with testicular pain with a negative HHD for torsion testis can be safely discharged from the emergency department.

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Do emergency physicians rely on point‐of‐care ultrasound for clinical decision making without additional confirmatory testing?

Abstract: This study describes the results of a survey on the use of EM-POCUS for clinical decision making by Ohio EPs. A majority of them continues to rely on gold standard testing for confirmatory diagnosis, in addition to EM-POCUS.

Cited by 7 publications

References 10 publications

Obstetric ultrasound: where are we and where are we going?

Obstetric ultrasound: where are we and where are we going?

New Perspectives for Modern Trauma Management – Lessons Learned from 25 Years FAST and 15 Years E-FAST

Evaluating Acute Testicular Pain Using Point-of-Care Hand-Held Doppler in the Emergency Department: A Prospective Pilot Study

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