POCUS Findings in Critically Ill Patients in Emergency Department

Abstract

Background: Point of care ultrasound (POCUS) has been shown to improve diagnostic accuracy and has been used in a variety of contexts. However, the utility of POCUS as applied to critically ill patients has not been well studied. Materials and Methods: This was a retrospective descriptive study of critically ill patients who had received POCUS at Srinagarind Hospital’s Emergency Medical Department between July 2019 and June 2020. Data was collected from one year of POCUS studies and included ultrasound clips and images, patient age and sex, chief complaint, final diagnosis, and patient disposition. The data was described using descriptive statistics, including medians, counts and percentages. Results: POCUS data was collected from 2,500 studies performed on 369 patients. Median patient age was 62.7 years; 51.6% of patients were female. Top indications of POCUS scans were of respiratory (34.42%) and cardiovascular system (23.58%) presentations. The most frequent study types performed were cardiac, lung, and inferior vena cava examinations. Abnormal ultrasound findings were found in 258 patients (69.92%). True-positive ultrasound results were found in 162 patients (43.9%). The admission rate of critically ill patients was highest among patients who had true-positive results. Conclusion: The prevalence of positive POCUS results was quite high in critically ill patients. Moreover, POCUS showed high accuracy. The number of admitted patients was highest among patients who had true-positive ultrasound results. Keywords: Ultrasonography, Critical illness, Emergency medicine