Point-of-care ultrasound in patients with suspected deep vein thrombosis (DVT)

Abstract

Background Suspicion of Deep vein thrombosis (DVT) is a frequent cause of presentation in emergency departments (EDs). Traditionally at Holbaek University Hospital, patients presenting with suspected lower-extremity DVT are commonly assessed and treated as out-patients in the Quick Diagnostic Unit (QDU), a part of our Emergency Department. The patients undergo D-dimer testing and Wells score followed by ultrasound (US) only if the D-dimer is positive, or the patient is judged clinically to have DVT (Wells score>2). Unfortunately, the limited availability of radiologist-performed ultrasound outside banker’s hours delay the diagnosis by more than 24 hours and may expose the patient to inappropriate anticoagulation treatment. The safety, ease of use, rapid time of diagnosis, low cost and accessibility makes bedside ultrasound for DVT especially useful for emergency physicians. The aim of this pilot study is to assess the time-todiagnosis and the accuracy of emergency physician performed bedside ultrasound (EPUS) in the detecting of pathological findings (Hematoma, Baker’s cyst and Thrombosis), in comparison with the traditional settings involving a radiologist-performed ultrasound.