How long does it take to perform emergency ultrasound for the primary indications?
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ORIGINAL ARTICLE
How long does it take to perform emergency ultrasound for the primary indications? Steven Socransky • Ray Wiss • Gary Bota Teresa Furtak
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Received: 13 July 2010 / Accepted: 26 October 2010 / Published online: 16 November 2010 Ó Springer-Verlag 2010
Abstract Purpose Although emergency ultrasound (EU) is gaining popularity, EU is performed in a minority of emergency departments (EDs). The perception may exist that EU is too time-consuming. This study sought to determine the duration of EUs performed for the primary indications by staff emergency physicians (EPs). Methods A prospective, time–motion study was conducted on a convenience sample of EUs at the Sudbury Regional Hospital ED from June to August 2006. All EPs had Canadian EU certification. A research assistant timed EUs. Primary EU indications in Canada are: cardiac arrest evaluation, rule-out pericardial effusion, rule-out intraperitoneal free fluid in trauma, rule-out abdominal aortic aneurysm, and rule-in intrauterine pregnancy. Descriptive statistics are reported. Results Eleven EPs performed 66 EUs for the primary indications on 51 patients. The mean EU duration was 137.8 s (range 11–465; CI 123.0–162.6). There was no difference in the duration of EUs performed by the two most experienced EPs (n = 37; duration = 129.4; CI = 96.4–162.4) compared to the other EPs (n = 29; duration = 148.4; CI = 110.6–186.2). Although subgroups were small, positive (n = 8; duration = 199.4; CI = 97.4–301.4), negative (n = 49; duration = 123.3; CI = 97.9–148.7), and indeterminate (n = 9; duration = 161.6; CI = 91.5–231.7) EUs did not differ in duration. There is some suggestion of differences in duration between types of EU, although again the subgroups were
S. Socransky (&) R. Wiss G. Bota T. Furtak Emergency Department, Sudbury Regional Hospital, 41 Ramsey Lake Road, Sudbury, ON P3E 5J1, Canada e-mail: [email protected]
small: cardiac (n = 21; duration = 90.3; CI = 62.6–118.0), abdominal (n = 22; duration = 157.1; CI = 111.9–202.3), aneurysm (n = 15; duration = 170.1; CI = 117.5–222.7), transabdominal pelvic (n = 5; duration = 89.8; CI = 40.3– 139.1), transvaginal (n = 3; duration = 246.0; CI = 30.6– 461.4). Conclusion When performed by staff EPs with EU certification, mean EU duration for the primary indications was brief regardless of EP’s experience, EU type, or results. Keywords Ultrasonography Emergency medicine Canada Time and motion studies
Introduction Evidence continues to mount that emergency ultrasound (EU) expedites critical diagnoses [1–4] and facilitates the performance of invasive procedures [5–7]. Emergency department (ED) throughput is enhanced by EU [8–10]. Furthermore, EU can be performed competently by nonradiologists after focused training [11–15]. Not surprisingly, the use of bedside EU continues to grow in academic EDs. Moore et al. [16] reported that 92% of academic EDs in the USA have EU 24 h per day. Despite this, the prevalence of EU in community EDs has lagged. Stein et al. [17] found that only 29% of comm
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