The diagnostic capabilities of the combined cardiac and lung point of care ultrasound in shocked patients at the emergency department – Resourced limited country

Ienghong, Kamonwon; Cheung, Lap Woon; Tiamkao, Somsak; Bhudhisawasdi, Vajarabhongsa; Apiratwarakul, Korakot

doi:10.1016/j.ejro.2022.100446

Cited by 4 publications

(5 citation statements)

References 32 publications

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“…Lung ultrasound is valuable and reproducible (8). In a population of patients with shock, studies have con icting results (12) considering a heterogenous population and different levels of training.…”

Section: Introductionmentioning

confidence: 99%

“…Since the introduction of point of care ultrasonography, many studies have evaluated the agreement between ultrasound ndings and formal ultrasonography. B lines, pleural effusion, dilated heart cavities, valvulopathies, and many other speci c alterations have been analyzed (9)(10)(11)(12). Most studies show good agreement between novice operator-performed ultrasound and experienced operator-performed ultrasound.…”

Section: Introductionmentioning

confidence: 99%

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Agreement of point of care ultrasound and final clinical diagnosis in patients with acute decompensated heart failure, acute coronary syndrome, and shock: POCUS not missing the target

Ramos,

Misol,

Petro

et al. 2024

Preprint

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Introduction: Point-of-Care ultrasound (POCUS) is an important tool for clinical diagnosis and decision-making in critical and non-critical scenarios. Dyspnea, chest pain and shock are conditions valuable to evaluate with ultrasound considering diagnostic accuracy and clinical impact already proven. There is scarce evidence in diagnosis agreement using ultrasound as an extension of physical examination. We aimed to evaluate ED patients in whom POCUS was performed, to analyze agreement between clinical initial diagnosis using ultrasound images and final diagnosis. Furthermore, we analyze failed diagnosis, inconclusive POCUS exams and discuss details. Methods: A cross-sectional analytical study was conducted in adults who visited the emergency department with any of these three chief complaints: dyspnea, chest pain, shock. All were evaluated with ultrasound at admission. Agreement between initial diagnosis using POCUS and final definite diagnosis was calculated. Failed diagnosis and inconclusive exams were analyzed. Results: A total of 209 patients were analyzed. Populations mostly males, mean age 64yo, hypertensive. Patients with dyspnea, agreement in heart failure diagnosis was 0.98; agreement in chest pain with non-ST acute coronary syndrome was 0.96; agreement in type of shock was 0.90. Twelve 12 (5%) patients had an inconclusive POCUS exam, and 16 (7%) patients had a failed diagnosis. Conclusion: The use POCUS in the emergency department shows almost perfect agreement when compared with the final diagnosis in individuals experiencing acutely decompensated heart failure, acute myocardial infarction, and shock. Prospective studies are needed to evaluate the impact of this tool on mortality and prognosis when there are diagnostic errors.

show abstract

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Agreement of point of care ultrasound and final clinical diagnosis in patients with acute decompensated heart failure, acute coronary syndrome, and shock: POCUS not missing the target

Ramos,

Misol,

Petro

et al. 2024

Preprint

View full text Add to dashboard Cite

show abstract

“…Since the introduction of point-of-care ultrasonography, many studies have evaluated the agreement between POCUS-specific findings compared to comprehensive ultrasonography, which is the ultrasound evaluation performed by radiologists and/or cardiologists as experts in the field. B lines, pleural effusion, dilated heart cavities, valvulopathies, and many other specific alterations have been analyzed [9][10][11][12]. Most studies show good agreement between novice operator-performed ultrasound and experienced operatorperformed ultrasound.…”

Section: Introductionmentioning

confidence: 99%

“…Lung ultrasound is valuable and reproducible [8]. In a population of patients with shock, studies have conflicting results [12] considering a heterogeneous population and different levels of training.…”

Section: Introductionmentioning

confidence: 99%

Agreement of point of care ultrasound and final clinical diagnosis in patients with acute heart failure, acute coronary syndrome, and shock: POCUS not missing the target

Núñez-Ramos,

Duarte-Misol,

Petro

et al. 2024

Intern Emerg Med

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Point-of-care ultrasound (POCUS) is an important tool for clinical diagnosis and decision-making in critical and non-critical scenarios. Dyspnea, chest pain, and shock are conditions susceptible to evaluation with ultrasound considering diagnostic accuracy and clinical impact already proven. There is scarce evidence in diagnosis agreement using ultrasound as an extension of physical examination. We aimed to evaluate ED patients in whom POCUS was performed, to analyze agreement between clinical initial diagnosis using ultrasound images and final diagnosis. Furthermore, we analyze failed diagnosis, inconclusive POCUS exams, and discuss details. A cross-sectional analytical study was conducted on adults who visited the emergency department with any of these three chief complaints: dyspnea, chest pain, and shock. All were evaluated with ultrasound at admission. Agreement between initial diagnosis using POCUS and final definite diagnosis was calculated. Failed diagnosis and inconclusive exams were analyzed. A total of 209 patients were analyzed. Populations: mostly males, mean age 64 years old, hypertensive. Agreement on patients with dyspnea and suspicion of acute decompensated heart failure was 0.98; agreement on chest pain suspicion of non-ST acute coronary syndrome was 0.96; agreement on type of shock was 0.90. Among the population, 12 patients had an inconclusive POCUS exam, and 16 patients had a failed diagnosis. The use of POCUS in the emergency department shows almost perfect agreement when compared with the final diagnosis in individuals experiencing acutely decompensated heart failure, acute coronary syndrome, and shock. Prospective studies are needed to evaluate the impact of this tool on mortality and prognosis when there are diagnostic errors.

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“…Particularly in emergency medicine (EM), POCUS is employed to aid in the assessment and management of various clinical conditions. [1][2][3][4] Its implementation has demonstrated a beneficial influence on clinical decision-making, leading to reduced emergency department (ED) and hospital stays. [5][6][7][8] However, challenges such as inadequate user training, difficulties in maintaining ultrasound proficiency, limitations in equipment availability for optimal imaging, and constraints on quality control impede broader application.…”

Section: Introductionmentioning

confidence: 99%

An in-Depth Examination of the Characteristics of Pre-Hospital Point-of-Care Ultrasound Training Among Emergency Medicine Residents in Laos as Part of an Overseas Elective Rotation

Ienghong,

Gaysonsiri,

Cheung

et al. 2023

AMEP

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Introduction Point of Care Ultrasound (POCUS) training has been offering invaluable guidance in the diagnostic process and treatment strategies, particularly in resource-limited settings. The purpose of this study was to determine participant satisfaction with the structure and scope of POCUS training in overseas elective rotation. Material and Methods A retrospective observational analytical study was undertaken. The study focused on EM residents from Laos who participated in the international elective rotation at the Khon Kaen University during the academic years 2020–2021 and 2022–2023. The research involved an exploration of training data related to this course, encompassing participant characteristics, the structure and scope of POCUS training, the training assessments, and post completion surveys of participants. Results The study involved 24 participants. The course was characterized by its status as an international elective program prehospital POCUS training for post graduate year 3 students. The duration of the rotation ranged from 2 to 4 weeks. Interestingly, in the academic year 2022–2023, the duration of POCUS training was notably extended to 8 hours, accounting for 4.76% of the total time. The training encompassed peer-to-peer didactic lectures, bedside teaching, and observational case studies at the Emergency Department (ED). The results of our survey, boasting a 100% response rate, indicated participants’ contentment with the academic performance, the abundance of learning resources, and the knowledge gained from this rotation that would aid their future careers. The overall satisfaction with this course was highly rated, falling into the “satisfy” and “highly satisfy” categories. However, certain challenges were reported, including feelings of isolation due to the distance from relatives, concerns related to interpersonal relationships with colleagues, and a sense of being isolated. Conclusion The participants were highly satisfied to the structure and scope of this course. The overseas elective rotation significantly enhanced the knowledge of Laos EM residents’ in POCUS and underscored the crucial importance of this course in EM training.

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The diagnostic capabilities of the combined cardiac and lung point of care ultrasound in shocked patients at the emergency department – Resourced limited country

Cited by 4 publications

References 32 publications

Agreement of point of care ultrasound and final clinical diagnosis in patients with acute decompensated heart failure, acute coronary syndrome, and shock: POCUS not missing the target

Agreement of point of care ultrasound and final clinical diagnosis in patients with acute decompensated heart failure, acute coronary syndrome, and shock: POCUS not missing the target

Agreement of point of care ultrasound and final clinical diagnosis in patients with acute heart failure, acute coronary syndrome, and shock: POCUS not missing the target

An in-Depth Examination of the Characteristics of Pre-Hospital Point-of-Care Ultrasound Training Among Emergency Medicine Residents in Laos as Part of an Overseas Elective Rotation

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