Impact of Bedside Lung Ultrasound on Physician Clinical Decision-making in an Emergency Department in Nepal

Overview

Journal Int J Emerg Med

Publisher Biomed Central

Specialty Emergency Medicine

Date 2020 Apr 5

PMID 32245366

Citations 4

Authors

Darlene R House

Yogendra Amatya

Benjamin Nti

Frances M Russell

Affiliations

Soon will be listed here.

Abstract

Background: Lung ultrasound is an effective tool for the evaluation of undifferentiated dyspnea in the emergency department. Impact of lung ultrasound on clinical decisions for the evaluation of patients with dyspnea in resource-limited settings is not well-known. The objective of this study was to evaluate the impact of lung ultrasound on clinical decision-making for patients presenting with dyspnea to an emergency department in the resource-limited setting of Nepal.

Methods: A prospective, cross-sectional study of clinicians working in the Patan Hospital Emergency Department was performed. Clinicians performed lung ultrasounds on patients presenting with dyspnea and submitted ultrasounds with their pre-test diagnosis, lung ultrasound interpretation, post-test diagnosis, and any change in management.

Results: Twenty-two clinicians participated in the study, completing 280 lung ultrasounds. Diagnosis changed in 124 (44.3%) of patients with dyspnea. Clinicians reported a change in management based on the lung ultrasound in 150 cases (53.6%). Of the changes in management, the majority involved treatment (83.3%) followed by disposition (13.3%) and new consults (2.7%).

Conclusions: In an emergency department in Nepal, bedside lung ultrasound had a significant impact on physician clinical decision-making, especially on patient diagnosis and treatment.

Citing Articles

Delphi Consensus Recommendations for the Development of the Emergency Medicine Point of Care Ultrasound (POCUS) Curriculum in Nepal.

Shrestha A, Blank W, Blank U, Horn R, Morf S, Shrestha S POCUS J. 2024; 9(2):133-142.

PMID: 39634678 PMC: 11616984. DOI: 10.24908/pocus.v9i2.17724.

Automatic B-lines: a tool for minimizing time to diuretic administration in pulmonary edema patients in the emergency department of a developing country.

Ienghong K, Cheung L, Chanthawatthanarak S, Apiratwarakul K Int J Emerg Med. 2024; 17(1):183.

PMID: 39623310 PMC: 11613477. DOI: 10.1186/s12245-024-00776-1.

The impact of lung ultrasound on clinical-decision making across departments: a systematic review.

Heldeweg M, Vermue L, Kant M, Brouwer M, Girbes A, Haaksma M Ultrasound J. 2022; 14(1):5.

PMID: 35006383 PMC: 8748548. DOI: 10.1186/s13089-021-00253-3.

Case Report: Lung Ultrasound for the Guidance of Adjunctive Therapies in Two Invasively Ventilated Patients with COVID-19.

Pierrakos C, Attou R, Iesu E, Baelongandi H, Honore P, Bos L Am J Trop Med Hyg. 2020; 103(5):1978-1982.

PMID: 32909535 PMC: 7646794. DOI: 10.4269/ajtmh.20-0538.

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