Key result
Advanced focused cardiac measurements add ~6.5 minutes to bedside ED exams with moderate feasibility.
Why the study?
Is it feasible to perform advanced focused cardiac ultrasound measurements in the emergency department, and how much additional time does it require?
Observational (n=53)
No
Is it feasible to perform advanced focused cardiac ultrasound measurements in the emergency department, and how much additional time does it require?
Advanced focused cardiac ultrasound measurements in the ED are feasible in about half of patients but add approximately 6.5 minutes to the examination time.
Supports feasibility of advanced focused cardiac ultrasound in select ED patients; leaves open workflow impact and need for prospective outcome trials.
BACKGROUND: This study aims to compare the increased time needed to perform advanced focused cardiac measurements in the emergency department, including diastolic heart failure evaluation via E/E', and cardiac output with LVOT/VTI. Patients with pertinent cardiopulmonary symptoms in the emergency department had a focused cardiac ultrasound performed by the emergency department ultrasound team. The ability to obtain basic cardiac windows, evaluate for effusion, systolic ejection fraction, and right-sided heart pressures were recorded. Advanced measurements, along with time to obtain all images and the training level of the provider, were recorded. RESULTS: Fifty-three patients were enrolled. Basic focused cardiac windows were able to be obtained in 80% of patients. The average 4-window focused cardiac ultrasound took 4 min and 49 s to perform. Diastolic measurements were able to be obtained in 51% of patients, taking an average of 3 min and 17 s. Cardiac output measurements were able to be obtained in 53% of patients, taking an average of 3 min and 8 s. CONCLUSION: The ability to obtain these images improved with increasing level of training. Performing both cardiac output and diastolic measurements increased the time with bedside ultrasound by 6 min and 25 s, and were able to be obtained in slightly over half of all ED patients.
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Betcher et al. (2018) conducted an observational in Undifferentiated cardiopulmonary symptoms (chest pain or dyspnea) (n=53). Advanced focused cardiac ultrasound (LVOT/VTI and E/E') was evaluated on Time needed to perform LVOT, VTI, E, and E' (p=<0.05). Advanced focused cardiac measurements were obtained in slightly over half of ED patients, adding an average of 6 minutes and 25 seconds to the bedside ultrasound examination.
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