Point of Care US in Patients Admitted with Respiratory Symptoms
The Article: Point-of-care ultrasonography in patients admitted with respiratory symptoms: a single blind, randomised controlled trial. Christian B Laursen et al. Lancet Respiratory Medicine 2014.
The idea: Whether point of care US of heart, lungs, and deep veins + diagnostic tests leads to a greater number of correct diagnoses at 4 hours of admission when compared with diagnostic tests alone.
The Study: Single blinded randomized control trial of 320 patients with respiratory symptoms. 160 received point of care US + diagnostic tests and the other 160 received just diagnostic tests (labs, CXR, CT, EKG).
The Findings: 139/158 in US group had correct diagnoses 88% versus 100/157, 63%. Absolute increase of 24% in patients who were correctly diagnosed at 4 hr and absolute incrase of 21% pts receiving appropriate treatment within 4 hr. However, there was no difference in patient centered outcomes such as mortality, ICU transfers, readmissions, hospital stay, and hospital free days.
The Takeaway: We should continue to use point of care US in the ED to aid in diagnosis and evaluation of ED patients as it is a safe, fast and cost effective tool. However, this should be targeted and individualized depending on the patient’s complaint and not generalized across the board to all patients.