Using lung ultrasound to differentiate patients in acute dyspnea in the prehospital emergency setting

Joshua S Rempell,Vicki E Noble

doi:10.1186/cc10226

Abstract

The diagnosis and treatment of dyspnea in the emergency department and in the prehospital setting is a challenge faced by the emergency physician and other prehospital care providers. While the use of lung ultrasound as a diagnostic tool in dyspneic patients has been well researched, there has been limited evaluation of its use in the prehospital setting. In the previous issue of Critical Care, Prosen and colleagues study the accuracy of lung ultrasound compared with both N-terminal pro-brain natriuretic peptide and the clinical examination for differentiating between acute decompensated congestive heart failure and chronic obstructive pulmonary disease exacerbations for patients in the prehospital setting. Their article adds to the growing body of evidence demonstrating the diagnostic efficacy of lung ultrasound in differentiating between these two disease processes in the acutely dyspneic patient.

Highlights

The diagnosis and treatment of dyspnea in the emergency department and in the prehospital setting is a challenge faced by the emergency physician and other prehospital care providers
There has been growing interest and evidence supporting the use of lung ultrasound as a diagnostic tool to help differentiate the various causes of dyspnea, most between patients with acute congestive heart failure and those with chronic obstructive pulmonary disease and asthma [1,2,3,4,5]
Prosen and colleagues found that seeing B-lines on the initial lung ultrasound had 100% sensitivity, 95% specificity, 100% negative predictive value, and 96% positive predictive value for the diagnosis of heart failure in the prehospital setting

Summary

Introduction

Acute dyspnea is a common, and often challenging, complaint both in the emergency department and in the prehospital setting. There has been growing interest and evidence supporting the use of lung ultrasound as a diagnostic tool to help differentiate the various causes of dyspnea, most between patients with acute congestive heart failure and those with chronic obstructive pulmonary disease and asthma [1,2,3,4,5]. Alines and B-lines, are fundamental in the use of lung ultrasound.

Results

Conclusion