Impact of Immediate Point-of-Care Ultrasound on Patients With Cardiopulmonary Symptoms in the Emergency Department

Yale University

Status: Completed

Conditions: Hypotension; Syncope; Dyspnea; Chest Pain

Treatments: Other: Usual care; Other: Point-of-care ultrasound

Study type: Interventional

Funder types: Other

Identifiers

NCT02861508

1605017729

Details and patient eligibility

About

The purpose of the proposed research is to examine whether incorporating point-of-care ultrasound (POCUS) early in diagnostic work-up of cardiopulmonary complaints will affect diagnosis, time to condition-specific intervention, and ultimately patient outcomes compared to usual care.

Enrollment: 170 patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Chief complaint of chest pain, dyspnea (either sudden onset or increased severity of chronic dyspnea), syncope, or hypotension (systolic blood pressure <100 or shock index [heart rate divided by systolic blood pressure] >1)

Exclusion criteria

• <18 years old
• Prisoner or ward of the state
• Trauma
• High acuity requiring treatment in resuscitation room
• Obvious cause of symptoms (e.g. acute GI bleed causing hypotension)
• Any form of "do not resuscitate" (DNR) order
• Roomed in hall of emergency department (location not amenable to ultrasound protocol)

Trial design

Primary purpose: Other

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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170 participants in 2 patient groups

Usual care

Active Comparator group

Description:

Usual care as determined by treating team. Ultrasound may still be part of the workup per the treating team's discretion.

Treatment:

Other: Usual care

Early POCUS

Experimental group

Description:

Point-of-care ultrasound protocol will involve cardiac views (for pericardial effusion, left ventricular function, left and right ventricular equality, aortic root dilation, and inferior vena cava status), lung views (for pneumothorax, signs of alveolar interstitial syndrome), abdominal views for free fluid, and a view of the abdominal aorta for aneurysm.

Treatment:

Other: Point-of-care ultrasound