Abdominal Pain (AP), Point of Care Ultrasound (POCUS), Triage
Conditions
Keywords
Emergency department, Abdominal pain, POCUS, Triage
Brief summary
Introduction and Objective: This study aimed to reveal the effect of classical triage and Bedside Focused Ultrasonography (POCUS) in addition to classical triage on diagnosis, treatment, emergency department follow-up and its relationship with triage models in patients presenting to the emergency department with abdominal pain complaints. METHOD: This randomized, controlled, prospective study was conducted with a total of 262 volunteer participants who were divided into two groups as 127 classical triage and 135 POCUS in addition to classical triage with non-traumatic abdominal pain. The decision of which participant would be included in which group was made at a 1:1 ratio using a computer-aided randomization table. The researcher did not intervene in the clinical processes in any way. In this study, the effect of POCUS application performed in addition to classical triage on clinical processes (imaging request, initial analgesia administration time, consultation request, emergency department stay and outcome) in the primary outcome and on triage systems in the secondary outcome were evaluated. IBM SPSS 21.0 software was used for statistical analysis of the data.
Interventions
OTHERPoint of care ultrasound (POCUS)
In this study, POCUS was performed by the same emergency medicine physician who had basic and advanced USG training and at least two years of POCUS experience, in accordance with ACEP imaging protocols. A portable USG device with B-Mode, M-Mode, Color Doppler, Power Doppler, Pulsed Wave Doppler modes, and which can be used in all clinical modes with a single probe was used during the protocol application (Butterfly iQ+™, Burlington, United States). Eight abdominal points (epigastric region, right upper quadrant, right side, right lower quadrant, suprapubic region, left lower quadrant, left side and upper quadrant, umbilical region) were scanned with POCUS, the findings were recorded on the previously prepared form, the triage categories of the patients (cl) were updated and the patients were directed to the area where they would be examined with the form.
Sponsors
Sakarya University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
DIAGNOSTIC
Masking
DOUBLE (Subject, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
* Present to the emergency room with abdominal pain * No history of trauma in the last 48 hours * Stable hemodynamics
Exclusion criteria
* According to the 3-way triage, the color code is red * Being under the age of 18 * Being pregnant * Having a history of trauma within the last 48 hours * Being morbidly obese * Having mental retardation * Having repeated emergency room visits * Being referred from the polyclinic to the emergency room with a diagnosis * Filling the study form incompletely
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Time to initial analgesia | 6 months | To evaluate the effect of adding the POCUS application to conventional triage on clinical processes, including imaging requests, time to initial analgesia. |
| Request for additional medical imaging | 6 months | To evaluate the effect of adding the POCUS application to conventional triage on imaging requests. |
| Emergency department length of stay | 6 months | To evaluate the effect of adding POCUS to conventional triage on the length of stay of patients in the emergency department. |
Other
| Measure | Time frame | Description |
|---|---|---|
| POCUS diagnostic sensitivity | 6 months | To determine the diagnostic sensitivity of POCUS performed during triage using the final reports of patients who requested imaging. |
| 3-group triage system Outcome Measure | 6 months | To examine the categorization changes after POCUS with 3-group triage system before POCUS application |
| Emergency severity index Outcome Measure | 6 months | To examine the categorization changes after POCUS with the emergency severity index before POCUS application. |
| Manchester Triage System Outcome Measure | 6 months | To examine the categorization changes after POCUS with Manchester triage system before POCUS application. |
Countries
Turkey (Türkiye)
Outcome results
None listed