Point-Of-Care Ultrasound-Driven vs Standard Diagnostic Pathway in Emergency Department Patients With Dyspnea (POCUS PATHWAY)

Aarhus University Hospital

Status: Completed

Conditions: Dyspnea

Treatments: Diagnostic Test: Point-of-care ultrasound-driven diagnostic pathway

Study type: Interventional

Funder types: Other

Identifiers

NCT05674916

pocuspathway

Details and patient eligibility

About

The POCUS PATHWAY-trial is a multi-center, randomized, investigator-initiated, open labelled, pragmatic, controlled trial of a point-of-care ultrasound-driven diagnostic pathway vs standard diagnostic pathway in dyspneic emergency department patients. The primary outcome will be 24-hour hospital stay and 642 patients will be included. Key secondary outcomes include overall hospital length of stay, image resources, and 72-hour revisits.

Enrollment: 674 patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

1. Emergency department contact
2. Age ≥ 18 years
3. Chief complaint is Dyspnea
4. Including physician present

Exclusion criteria

1. Fulfilling of criteria for coded rapid-response teams (i.e., trauma, surgical or medical emergencies).
2. Prior focused lung or focused cardiac ultrasound in the current emergency department stay
3. Prior enrollment in the trial
4. Unable to consent
5. Non Danish-speaking

Trial design

Primary purpose: Diagnostic

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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674 participants in 2 patient groups

Point-of-care ultrasound-driven diagnostic pathway

Experimental group

Description:

The intervention is focused lung and cardiac ultrasound performed as an extension to physical examinations plus diagnostic decision recommendations based on those test results (a point-of-care ultrasound-driven diagnostic pathway). Final decision on next-line imaging and further diagnostic testing should incorporate history and other physical examinations and will remain upon the treating physicians' discretion.

Treatment:

Diagnostic Test: Point-of-care ultrasound-driven diagnostic pathway

Standard diagnostic pathway

No Intervention group

Description:

Standard diagnostic pathway will include, but not be limited to, blood samples, blood gases, electrocardiogram, and chest x-ray. Focused lung and cardiac ultrasound cannot be performed while the patients stay in the emergency department.