POCUS trial - Emergency Medicine Podcasts

Report
POCUS TRIAL
HEFTEMCAST
USS IN CARDIAC ARREST
Meta analysis from Blyth 2012 showed;
Cardiaic motility as a predictor of ROSC
Positive likelihood ratio 4.26 (95% CI = 2.63 to 6.92),
Negative likelihood ratio was 0.18
THE PAPER
Laursen, Christian B., et al. "Point-of-care ultrasonography in
patients admitted with respiratory symptoms: a single-blind,
randomised controlled trial." The Lancet Respiratory Medicine
(2014).
The POCUS trial
PATIENTS
Prospective RCT
Single centre hospital, Denmark
Inclusion criteria
RR > 20 bpm, SpO2 < 95%, commenced on O2 therapy
Description of current/previous dyspnoea/cough/chest pain were screened for
eligibility
Exclusion criteria
Mental disability, < 18 years of age, point of care USS not performed with 1 hr after
the primary assessment
INTERVENTION
Control group had a standard diagnostic work up
POC group had the standard work up + USS of heart and lungs and deep veins in the legs
The results of the USS were communicated to the clinician providing clinical care for the
patient to inform their diagnostics and management plan
COMPARISON
Compared diagnosis at 4hrs matched with the discharge diagnosis
OUTCOME
Correct diagnosis 88% (POC) vs 64% (control) p-value <0.0001
REFERNECES
•
Vidakovik R, Feringa HH, Kuiper RJ, Karagiannis SE, Schouten O, Dunkelgrun M, Hoeks
SE, Bom N, Bax JJ, Neskovic AN, Poldermans D. Comparison with computed tomography
of two ultrasound devices for diagnosis of abdominal aortic aneurysm. Am J Cardiol 2007
Dec15;100 (12):1786 91.
•
Dent B, Kendall RJ, Boyle AA, Atkinson PR. Emergency ultrasound of the abdominal aorta
by UK emergency physicians: a prospective cohort study. Emerg Med J. 2007
Aug;24(8):547-9.
•
Taval VS, Graf CD, Gibbs MA. Prospective study of accuracy and outcome of emergency
ultrasound for aortic aneurysm over two years. Acad Emerg Med. 2003 Aug;10(8):867-71
•
Blyth, L., Atkinson, P., Gadd, K. and Lang, E. (2012), Bedside Focused Echocardiography
as Predictor of Survival in Cardiac Arrest Patients: A Systematic Review. Academic
Emergency Medicine, 19: 1119–1126.

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