None listed
Conditions
Brief summary
Pleural effusions are a collection of fluid that can develop in the space around the lung. This study is looking to see whether emergency doctors, after focused training, can use bedside 'point of of care' ultrasound (POCUS) to assess pleural effusions in children as accurately as traditional ultrasound done by specialists. If this are shown to be accurate, further research could then be undertaken to assess if this would expedite management. The study will involve an emergency department doctor undertaking a bedside ultrasound in addition to the formal ultrasound routinely undertaken by a specialised ultrasonographer in children who present to the emergency department with a pleural effusion who would routinely require an ultrasound. The diagnosis of a pleural effusion, size and complexity and time to obtain results of each type of ultrasound will be reviewed.
Interventions
Results of a point of care ultrasound undertaken by an emergency department physician will be compared to the results of a formal ultrasound undertaken by a specialised ultrasonographer to compare the accuracy of point of care ultrasound for diagnosing and assessing pleural effusions in paediatric patients in the emergency department. This study will involve a point of care ultrasound being undertaken by an emergency department physician in addition to have routine ultrasound undertaken by an ul
Results of a point of care ultrasound undertaken by an emergency department physician will be compared to the results of a formal ultrasound undertaken by a specialised ultrasonographer to compare the accuracy of point of care ultrasound for diagnosing and assessing pleural effusions in paediatric patients in the emergency department. This study will involve a point of care ultrasound being undertaken by an emergency department physician in addition to have routine ultrasound undertaken by an ultrasonographer, as is currently standard clinical practice. The point of care ultrasound will be undertaken in patients who require a formal ultrasound at time of review or are suspected to require one within 24 hours, if a formal ultrasound is not undertaken the patient will be withdrawn from the study. There is no set timing that the formal or point of care ultrasounds need to be undertaken in following presentation to the emergency department; the timing of each type of ultrasound will be documented to see if there is a difference. The time of ultrasound completion and time of obtaining results of each type of ultrasound will also be documented. Management for participants will not change from standard practice and will be based on the formal ultrasound results. Focused training will involve a one off didactic teaching session of around 1 hour duration followed by practical skills session of around 1 hour duration undertaken by paediatric emergency consultants experienced in ultrasound (>5 years experience) and a paediatric emergency department fellow. For participants, this study will involve a point of care ultrasound being undertaken in the emergency department in additional to the routine formal ultrasound that would be undertaken as standard practice. There will be no further participant input required. The medical records of participants will be reviewed to obtain additional information such as chest xray results, results and time frame of formal ultrasonography, final diagnosis, treatment undertaken and length of admission.
Sponsors
Women's and Children's Hospital Emergency Department
Study design
Allocation
Non-randomised trial
Intervention model
Single group
Primary purpose
Diagnosis
Eligibility
Sex/Gender
All
Age
No minimum to 18 Years
Healthy volunteers
No
Inclusion criteria
• Patients less than 18 years of age • All patients presenting to the emergency department with suspicion of a pleural effusion clinically or on xray, who would routinely require a formal ultrasound at time of assessment or may require one within 24 hours
Exclusion criteria
• Severe clinical instability that does not allow time for additional ultrasound to be undertaken • Pleural effusion in the setting of trauma • Known malignancy • No emergency department physician on shift who has completed the lung POCUS training • Formal ultrasound already obtained at another institution or CT chest undertaken
Outcome results
None listed