A bedside ultrasound in general medicine patients with cardiopulmonary diagnosis.

Conditions

None listed

Brief summary

The project investigates the clinical impact of adding a basic bedside ultrasound examination to the standard clinical evaluation of patients admitted to a General Medicine wards with symptoms reflecting a cardiac or respiratory problem. It is a randomised trial. Randomisation means that patients will be assigned in one of the groups by a method similar to flipping a coin, uncontrolled by the researcher. In this study participants will be randomised and allocated into two groups. One group will receive a focused ultrasound examination of the heart, lung and lower extremity veins, performed by a general physician during the first 24 hours at the unit. This test takes around 20 minutes to be completed and it does not add any risk to the patient. The result of the ultrasound will be given to the treating physician, who will decide the treatment and further investigations. The second group will receive standard care, in which a bedside ultrasound examination is not part of usual practice. We will compare the length of stay at the hospital in both groups. We are expecting that this focused ultrasound will improve the work-flow by helping physician narrow down the possible diagnoses faster and guiding management. This may result in reduced length of stay. We aim to see if length of stay at the hospital can be reduced by 24 hours.

Ximena Cid‐Serra, Alistair Royse, David Canty, Douglas Johnson, Andrea B. Maier et al. (8 authors)

JAMA Network Open2021-12-2119 citations

10.1001/jamanetworkopen.2021.38228

Impact of point-of-care ultrasound on the hospital length of stay for internal medicine inpatients with cardiopulmonary diagnosis at admission: study protocol of a randomized controlled trial-the IMFCU-1 (Internal Medicine Focused Clinical Ultrasound) study.

Cid X, Canty D, Royse A, Maier AB, Johnson D, El-Ansary D, Clarke-Errey S, Fazio T, Royse C.

2020-01-088 citations

10.1186/s13063-019-4003-2

Interventions

A bedside ultrasound done by a physician trained in focused ultrasonography. The ultrasound involves scan of the heart, lungs and two lower extremity veins (femoral and popliteal). All the patients allocated to the interventional group will receive the same ultrasound examination. The study takes around 20 minutes to be performed. The quality of the technique will be assess by an expert in echocardiography and bedside ultrasound, who will check the images and videos recorded. Additionally, if

A bedside ultrasound done by a physician trained in focused ultrasonography. The ultrasound involves scan of the heart, lungs and two lower extremity veins (femoral and popliteal). All the patients allocated to the interventional group will receive the same ultrasound examination. The study takes around 20 minutes to be performed. The quality of the technique will be assess by an expert in echocardiography and bedside ultrasound, who will check the images and videos recorded. Additionally, if the patient goes to a formal investigation (echocardiography or CT chest scan), the results of the bedside ultrasound will be cross checked with the report of these tests.

Study design

Allocation

Randomised controlled trial

Intervention model

Parallel

Primary purpose

Diagnosis

Masking

Open (masking not used)

Eligibility

Sex/Gender

All

Age

18 Years to No maximum

Healthy volunteers

No

Inclusion criteria

Adult patients admitted to a general medicine unit at the Royal Melbourne Hospital with a cardiopulmonary diagnosis and are expected to remain in hospital longer than 24 hours

Exclusion criteria

Already admitted for longer than 24 hours Admitted for social reasons rather than medical Have received a transthoracic echocardiography within 4 weeks prior admission or a CT chest scan during the admission process prior to enrolment.

Outcome results