The clinical impact and prevalence of emergency point-of-care ultrasound: A prospective multicenter study

• DOI: 10.1016/j.accpm.2017.02.008
• Publication Date: 2017-04-13T08:18:27Z
• Authors: Xavier Bobbia; Laurent Zieleskie...; Christophe Pradei...; Chloé Hudson; Laurent Muller; Pierre Géraud Claret; Marc Leone; Jean-Emmanuel de ...
• Keywords: Adult; Male; Emergency Medical Services; [SDV.MHEP] Life Sciences [q-bio]/Human health and pathology; Point-of-Care Systems; Middle Aged; 3. Good health; 03 medical and health sciences; 0302 clinical medicine; 616; 617; Prevalence; Humans; Wounds and Injuries; Female; Prospective Studies; [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology; Aged; Ultrasonography

The main objectives of our study were to evaluate the prevalence of emergency point-of-care ultrasound (POCUS) use and to assess the impact of POCUS on: diagnostic, therapeutic, patient orientation and imaging practices.This was a one-day, prospective, observational study carried out across multiple centers. Fifty emergency departments (EDs) recorded all POCUS performed over a 24h period. The prevalence of POCUS was defined as the number of POCUS/number of patients seen in all units. The "diagnostic impact" was defined as a POCUS-induced confirmation or change to the initial clinical diagnosis. The "therapeutic impact" was defined as a POCUS-induced change in treatment. The "orientation impact" was defined as an ultrasound-induced confirmation or change in the initial orientation. The "imaging change" was defined as a radiologic imaging prescription modification.Two hundred and twenty-nine (5%) POCUS were performed on 192 patients (4%) from among the 4671 patients seen on the study day in the 50 EDs. No ultrasound procedural guidance was given during the study day. The diagnostic, therapeutic and orientation impacts were respectively 82%, 47% and 85%. In 101 cases (44%), POCUS led to at least one imaging change. The clinical value of POCUS, i.e. considering at least one impact and/or imaging change, was assessed at 95%.This study shows that POCUS is used on a minority of emergency patients. However, when used, it significantly affects diagnostic and therapeutic practices in the emergency setting.