POCUS slashes diagnosis times in emergency room
Point-of-care lung ultrasound (PoC-LUS) could expedite the diagnostic process in busy emergency rooms, allowing providers to quickly initiate treatment for patients presenting with respiratory symptoms.
Acute dyspnea is a common reason patients present to the ER. It often requires an extensive workup that typically includes imaging of some sort—most often CT. This workup can be time-consuming and, in some cases, delay treatment. As such, there is an unmet need for diagnostic tools that could expedite care.
A new paper published in Emergency Radiology proposes PoC-LUS as a viable option.
“Although thoracic CT ... is the gold standard for lung imaging, it is radiating, expensive, and the time to scan and to obtain an interpretation is long,” Iulian Buzincu, with the Clinical Emergency County Hospital “St. Spiridon” in Romania, and colleagues explained. “Point of care lung ultrasound is a rapid, immediately available, noninvasive bedside technique that allows for the diagnosis of many respiratory pathologies with good accuracy and greater speed compared to the gold standard lung imaging technique.”
The team recently retrospectively compared the concordance between emergency physicians’ rapid diagnoses using PoC-LUS and attending physicians’ determinations using CT imaging as part of their diagnostic process. They sought to determine whether shorter time to diagnosis for dyspnea would impact diagnostic accuracy and, therefore, treatments.
After analyzing data acquired over a two-year period, the group observed excellent agreement between emergency physician and attending physician diagnoses for all etiologies of dyspnea, including pleural effusion, pneumonia, bronchopneumonia, acute pulmonary edema, chronic obstructive pulmonary disease exacerbation, pleuropulmonary tumors and acute respiratory distress syndrome. However, the time required to make a diagnosis differed significantly between both providers, with emergency physicians taking an average of 16(±4) minutes compared to 480(±112) for attending physicians.
“This is potentially very important for an emergency diagnosis in which a rapid treatment may be associated with better prognosis,” the authors noted. “Improvements in the survival rate in the critically ill patients admitted in the EDs are directly related to early recognition and rapid initiation of treatment.”
The group added that use of PoC-LUS could also limit risks related to transporting patients who may be in a critical state, adding to its potential as a valuable diagnostic tool in emergency settings.
Learn more about the team’s findings here.
In addition to her background in journalism, Hannah also has patient-facing experience in clinical settings, having spent more than 12 years working as a registered rad tech. She began covering the medical imaging industry for Innovate Healthcare in 2021.