Chest Pain, Cough, Dyspnoea
Conditions
Brief summary
The purpose of this study is to determine whether focused sonography of the heart, lungs and deep veins can increase the number of patients with respiratory symptoms correctly diagnosed in an emergency department.
Interventions
OTHERFocused Sonography of the heart, lungs and deep veins
The patient is randomised to either a control group where usual treatment and diagnostic work-up is performed or to an intervention group where usual treatment and diagnostic workup are supplemented by a sonographic examination of the heart, lungs and deep veins are performed within one hour after the primary evaluation. The primary evaluation is defined as the first evaluation of the patient by a physician in the Acute Medical Admission Department.
Sponsors
University of Southern Denmark
Odense University Hospital
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
DIAGNOSTIC
Masking
SINGLE (Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
All 4 of the following must be present: 1. The sonographic examination can be performed before or within 1 hour after the primary evaluation 2. Patient is 18 years or older 3. Patient able and willing to give informed consent 4. One ore more of the following symptoms or clinical findings at admission to the emergency department * Respiratory rate \> 20 breaths per minute * Saturation \< 95% * Oxygen therapy initiated * The patient has a principal complaint of dyspnoea * The patient has a principal complaint of coughing * The patient has a principal complaint of chest pain
Exclusion criteria
One of the following: 1. The sonographic examination can not be performed within 1 hour after the primary evaluation 2. The patient is 17 years or younger 3. The patient not able or willing to give informed consent
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| The number of patients with a correct presumptive diagnosis within 4 hours after hospital admission. | 4 hours after hospital admission | The 4-hour presumptive diagnosis are compared to the final diagnosis obtained by audit after the patient has been discharged from the hospital (gold standard). |
Secondary
| Measure | Time frame |
|---|---|
| Sensitivity, specificity, positive predictive values, negative predictive values and diagnostic accuracy of the primary evaluation and the 4-hour presumptive diagnosis. | Participants will be followed for the duration of the hospital stay, an expected range of up to 5 weeks |
| Number of patients receiving appropriate, inappropriate and no specific treatment 4-hours after admission | Participants will be followed for the duration of the hospital stay, an expected range of up to 5 weeks |
| 30 day mortality | 30 days after the patient has been admitted to the hospital |
| In-hospital mortality | Participants will be followed for the duration of the hospital stay, an expected range of up to 5 weeks |
| Number of patients with a correct presumptive diagnosis after primary evaluation in the control group and after sonography in the intervention group. | Participants will be followed for the duration of the hospital stay, an expected range of up to 5 weeks |
| Number of patients given an appropriate, inappropriate and no specific treatment after primary evaluation in the control group and after sonography in the intervention group | Participants will be followed for the duration of the hospital stay, an expected range of up to 5 weeks |
| Time to diagnostic / therapeutic thoracocentesis | Participants will be followed for the duration of the hospital stay, an expected range of up to 5 weeks |
| Length of hospital stay | Participants will be followed for the duration of the hospital stay, an expected range of up to 5 weeks |
| Number of patients transferred to an intensive care unit | Participants will be followed for the duration of the hospital stay, an expected range of up to 5 weeks |
Countries
Denmark
Outcome results
None listed