None listed
Conditions
Brief summary
We are undertaking research into the use of ultrasound to diagnose pneumonia in children. Currently, doctors may order a chest X-ray if they are concerned a child has pneumonia. Studies that have looked into this in children and adults suggest that ultrasound of the lungs may be as good as chest X-ray at identifying pneumonia and it has the added advantage of being at the patient’s bedside and not exposing the child to radiation. We aim to perform a lung ultrasound on children in the emergency department who have had a chest X-ray ordered by their treating doctor. We will then compare the results of the X-ray and the ultrasound to see whether the ultrasound has similar findings. Lastly, we will perform a follow-up phone interview 2-3 weeks after each child has been discharged from the emergency department to document if they improved, whether or not they needed antibiotics, or subsequently needed to consult another doctor. We hope our study will provide support to the growing idea that lung ultrasound may is useful for diagnosing pneumonia. In addition, we hope that we may begin to understand when it would be a good idea for the child to still have a chest X-ray and when the findings of a lung ultrasound are sufficient. This information may guide future research into using lung ultrasound to diagnose pneumonia.
Interventions
Patients for whom a CXR has been ordered to confirm or exclude pneumonia will be identified in the emergency department. The patient's doctor will be approached to determine exclusion criteria and then the parent/guardian will be approached for consent. The informed consent process will include provision of a plain language statement. Children >12 years will be given the option to consent in addition to their parent/guardian.
A lung ultrasound will be performed within 12 hours of the CXR and th
Patients for whom a CXR has been ordered to confirm or exclude pneumonia will be identified in the emergency department. The patient's doctor will be approached to determine exclusion criteria and then the parent/guardian will be approached for consent. The informed consent process will include provision of a plain language statement. Children >12 years will be given the option to consent in addition to their parent/guardian. A lung ultrasound will be performed within 12 hours of the CXR and these LUS findings will be recorded. The lung ultrasound will take approximately 10 minutes and will follow a protocol covering upper and lower zones of the anterior, lateral and posterior chest. Both sagittal/longitudinal and transverse/oblique views will be performed in all 6 lung zones of each hemithorax. The treating doctor will complete a survey of the patient's clinical features as well as their interpretation of the CXR. From the patient's medical records the following information will be obtained: the radiologist's CXR report, the discharge diagnosis, whether the patient was admitted at their first visit and whether antibiotics were prescribed. A follow-up phone call will be performed 2-3 weeks after the lung ultrasound to determine patient outcomes: admission to hospital, the prescription of antibiotics and patient adherence, further CXRs performed, and further GP and ED attendances and the reasons for attendance. The follow up call will take less than 10 minutes.
Sponsors
Emergency Department - The Royal Children's Hospital
Eligibility
Sex/Gender
All
Age
1 Months to 18 Years
Healthy volunteers
No
Inclusion criteria
1. A CXR has been ordered by the treating doctor or emergency department staff member to confirm or exclude pneumonia.
Exclusion criteria
1. Children <1 month or >18 years at the time of enrolment. 2. Children who arrive to the emergency department with a CXR already taken for their current illness eg ordered by their GP. 3. Children who are receiving CPR, ventilation or other life support interventions. 4. Consent not given.
Outcome results
None listed