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The Frequency of POCUS in the Treatment of Sepsis in the Emergency Department: A Retrospective Cohort Study

Background: Point of care ultrasound (POCUS) is ubiquitous in the modern emergency department (ED). POCUS can be helpful in the management of patients with sepsis in many ways including determining the cause of sepsis, assessing fluid status, guiding resuscitation, and performing procedures. However...

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Autores principales: Dalla Betta, M Bryan, Esener, Dasia, Swanson, William, Kaddis, Andrew, Aguayo Romero, Felipe, Fields, J Matthew
Formato: Online Artículo Texto
Lenguaje:English
Publicado: CINQUILL Medical Publishers Inc 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10155732/
https://www.ncbi.nlm.nih.gov/pubmed/37152333
http://dx.doi.org/10.24908/pocus.v8i1.15683
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author Dalla Betta, M Bryan
Esener, Dasia
Swanson, William
Kaddis, Andrew
Aguayo Romero, Felipe
Fields, J Matthew
author_facet Dalla Betta, M Bryan
Esener, Dasia
Swanson, William
Kaddis, Andrew
Aguayo Romero, Felipe
Fields, J Matthew
author_sort Dalla Betta, M Bryan
collection PubMed
description Background: Point of care ultrasound (POCUS) is ubiquitous in the modern emergency department (ED). POCUS can be helpful in the management of patients with sepsis in many ways including determining the cause of sepsis, assessing fluid status, guiding resuscitation, and performing procedures. However, the frequency and manner in which POCUS is incorporated into the care of septic patients in community emergency medicine remains unclear. Objective: To evaluate POCUS frequency and exam types used in the care of patients with sepsis in two community EDs in Southern California. Methods: We performed a retrospective analysis of 5,264 ED visits with a diagnosis of sepsis at two community emergency departments between January 2014 and December 2018. Patients 18 years or older who were diagnosed with sepsis and had either lactate ≥ 4 mmol, a documented mean arterial pressure (MAP) < 65 mmHg, or a systolic blood pressure (SBP) < 90 mmHg were included. Charts were reviewed to determine if POCUS was used during the ED evaluation. Primary outcomes were frequency of POCUS use in the cohort, change in POCUS use over the study period, and the types of exams performed. Results: POCUS was used in 21% of encounters meeting inclusion criteria and was positively correlated with ED arrival year (OR = 1.09; CI 1.04, 1.15; p=0.001). The most common POCUS exam was ultrasound-guided central line placement, with the next most common exams being cardiac, followed by inferior vena cava (IVC). Only the frequency of cardiac, IVC, lung and Focused Assessment with Sonography in Trauma (FAST) exams were found to increase significantly over the study period. Conclusions: Total POCUS use increased significantly in this cohort of septic patients over the study period due to more cardiac, IVC, lung and FAST exams being performed.
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spelling pubmed-101557322023-05-04 The Frequency of POCUS in the Treatment of Sepsis in the Emergency Department: A Retrospective Cohort Study Dalla Betta, M Bryan Esener, Dasia Swanson, William Kaddis, Andrew Aguayo Romero, Felipe Fields, J Matthew POCUS J Medicine Background: Point of care ultrasound (POCUS) is ubiquitous in the modern emergency department (ED). POCUS can be helpful in the management of patients with sepsis in many ways including determining the cause of sepsis, assessing fluid status, guiding resuscitation, and performing procedures. However, the frequency and manner in which POCUS is incorporated into the care of septic patients in community emergency medicine remains unclear. Objective: To evaluate POCUS frequency and exam types used in the care of patients with sepsis in two community EDs in Southern California. Methods: We performed a retrospective analysis of 5,264 ED visits with a diagnosis of sepsis at two community emergency departments between January 2014 and December 2018. Patients 18 years or older who were diagnosed with sepsis and had either lactate ≥ 4 mmol, a documented mean arterial pressure (MAP) < 65 mmHg, or a systolic blood pressure (SBP) < 90 mmHg were included. Charts were reviewed to determine if POCUS was used during the ED evaluation. Primary outcomes were frequency of POCUS use in the cohort, change in POCUS use over the study period, and the types of exams performed. Results: POCUS was used in 21% of encounters meeting inclusion criteria and was positively correlated with ED arrival year (OR = 1.09; CI 1.04, 1.15; p=0.001). The most common POCUS exam was ultrasound-guided central line placement, with the next most common exams being cardiac, followed by inferior vena cava (IVC). Only the frequency of cardiac, IVC, lung and Focused Assessment with Sonography in Trauma (FAST) exams were found to increase significantly over the study period. Conclusions: Total POCUS use increased significantly in this cohort of septic patients over the study period due to more cardiac, IVC, lung and FAST exams being performed. CINQUILL Medical Publishers Inc 2023-04-26 /pmc/articles/PMC10155732/ /pubmed/37152333 http://dx.doi.org/10.24908/pocus.v8i1.15683 Text en Copyright (c) 2023 Bryan Dalla Betta, Dasia Esener, William Swanson, Andrew Kaddis, Felipe Aguayo Romero, Matthew Fields https://creativecommons.org/licenses/by/4.0/ This work is licensed under a Creative Commons Attribution 4.0 International License (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Medicine
Dalla Betta, M Bryan
Esener, Dasia
Swanson, William
Kaddis, Andrew
Aguayo Romero, Felipe
Fields, J Matthew
The Frequency of POCUS in the Treatment of Sepsis in the Emergency Department: A Retrospective Cohort Study
title The Frequency of POCUS in the Treatment of Sepsis in the Emergency Department: A Retrospective Cohort Study
title_full The Frequency of POCUS in the Treatment of Sepsis in the Emergency Department: A Retrospective Cohort Study
title_fullStr The Frequency of POCUS in the Treatment of Sepsis in the Emergency Department: A Retrospective Cohort Study
title_full_unstemmed The Frequency of POCUS in the Treatment of Sepsis in the Emergency Department: A Retrospective Cohort Study
title_short The Frequency of POCUS in the Treatment of Sepsis in the Emergency Department: A Retrospective Cohort Study
title_sort frequency of pocus in the treatment of sepsis in the emergency department: a retrospective cohort study
topic Medicine
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10155732/
https://www.ncbi.nlm.nih.gov/pubmed/37152333
http://dx.doi.org/10.24908/pocus.v8i1.15683
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