Article Instance

HTTP 200 OK
Allow: GET
Content-Type: application/json
Vary: Accept

{
    "pk": 13694,
    "title": "Point-of-care Ultrasound in Morbidity and Mortality Cases in Emergency Medicine: Who Benefits the Most?",
    "subtitle": null,
    "abstract": "Introduction:\n Point-of-care ultrasound (POCUS) is an essential tool in the timely evaluation of an undifferentiated patient in the emergency department (ED). Our primary objective in this study was to determine the perceived impact of POCUS in high-risk cases presented at emergency medicine (EM) morbidity and mortality (M&M) conferences. Additionally, we sought to identify in which types of patients POCUS might be most useful, and which POCUS applications were considered to be highest yield.\nMethods:\n This was a retrospective survey of cases submitted to M&M at an EM residency program that spans two academic EDs, over one academic year. Postgraduate year 4 (PGY) residents who presented M&M cases at departmental sessions were surveyed on perceived impacts of POCUS on individual patient outcomes. We evaluated POCUS use and indications while the POCUS was used.\nResults: \nOver the 12-month period, we reviewed 667 cases from 18 M&M sessions by 15 PGY-4 residents and a supervising EM attending physician who chairs the M&M committee. Of these cases, 75 were selected by the M&M committee for review and presentation. POCUS was used in 27% (20/75) of the cases and not used in 73% (55/75). In cases where POCUS was not used, retrospective review determined that if POCUS had been used it would have “likely prevented the M&M” in 45% (25/55). Of these 25 cases, the majority of POCUS applications that could have helped were cardiac (32%, 8/25) and lung (32%, 8/25) ultrasound. POCUS was felt to have greatest potential in identifying missed diagnoses (92%, 23/25), and decreasing the time to diagnosis (92%, 23/25). Patients with cardiopulmonary chief complaints and abnormal vital signs were most likely to benefit. There were seven cases (35%, 7/20, 95% CI 15-59%) in which POCUS was performed and thought to have possibly adversely affected the outcome of the M&M.\nConclusion: \nPOCUS was felt to have the potential to reduce or prevent M&M in 45% of cases in which it was not used. Cardiac and lung POCUS were among the most useful applications, especially in patients with cardiopulmonary complaints and in those with abnormal vital signs.",
    "language": "en",
    "license": {
        "name": "Creative Commons Attribution 4.0",
        "short_name": "CC BY 4.0",
        "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.",
        "url": "https://creativecommons.org/licenses/by/4.0"
    },
    "keywords": [
        {
            "word": "point-of-care ultrasound"
        },
        {
            "word": "education"
        },
        {
            "word": "Morbidity and Mortality"
        }
    ],
    "section": "Health Outcomes",
    "is_remote": true,
    "remote_url": "https://escholarship.org/uc/item/9sv201vz",
    "frozenauthors": [
        {
            "first_name": "Andrew",
            "middle_name": "",
            "last_name": "Goldsmith",
            "name_suffix": "",
            "institution": "Harvard Medical School, Department, Boston, Massachusetts\nBrigham and Women’s Hospital, Department of Emergency Medicine, Boston, Massachusetts",
            "department": "None"
        },
        {
            "first_name": "Hamid",
            "middle_name": "",
            "last_name": "Shokoohi",
            "name_suffix": "",
            "institution": "Harvard Medical School, Department, Boston, Massachusetts\nMassachusetts General Hospital, Department of Emergency Medicine, Boston, Massachusetts",
            "department": "None"
        },
        {
            "first_name": "Michael",
            "middle_name": "",
            "last_name": "Loesche",
            "name_suffix": "",
            "institution": "Harvard Medical School, Department, Boston, Massachusetts\nBrigham and Women’s Hospital, Department of Emergency Medicine, Boston, Massachusetts\nMassachusetts General Hospital, Department of Emergency Medicine, Boston, Massachusetts",
            "department": "None"
        },
        {
            "first_name": "Ravish",
            "middle_name": "C.",
            "last_name": "Patel",
            "name_suffix": "",
            "institution": "Massachusetts General Hospital, Department of Emergency Medicine, Boston, Massachusetts\nMedical College of Georgia School of Medicine, Department, Augusta, Georgia",
            "department": "None"
        },
        {
            "first_name": "Heidi",
            "middle_name": "",
            "last_name": "Kimberly",
            "name_suffix": "",
            "institution": "Harvard Medical School, Department, Boston, Massachusetts\nBrigham and Women’s Hospital, Department of Emergency Medicine, Boston, Massachusetts",
            "department": "None"
        },
        {
            "first_name": "Andrew",
            "middle_name": "",
            "last_name": "Liteplo",
            "name_suffix": "",
            "institution": "Harvard Medical School, Department, Boston, Massachusetts\nMassachusetts General Hospital, Department of Emergency Medicine, Boston, Massachusetts",
            "department": "None"
        }
    ],
    "date_submitted": "2020-03-29T19:04:34Z",
    "date_accepted": "2020-03-29T19:04:34Z",
    "date_published": "2020-11-04T08:00:00Z",
    "render_galley": null,
    "galleys": [
        {
            "label": "",
            "type": "pdf",
            "path": "https://journalpub.escholarship.org/westjem/article/13694/galley/7153/download/"
        }
    ]
}