BRIPPED scan for evaluation of ED patients with shortness of breath
| Autor: | Donald V. Byars, Hjalti M. Bjornsson, Michelle Clinton, Virginia M. Stewart |
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| Rok vydání: | 2016 |
| Předmět: |
Male
medicine.medical_specialty Pericardial effusion Inferior vena cava Diagnosis Differential 03 medical and health sciences 0302 clinical medicine Clinical Protocols medicine Humans Prospective Studies Prospective cohort study Ultrasonography business.industry Reproducibility of Results 030208 emergency & critical care medicine General Medicine Emergency department Middle Aged medicine.disease Surgery Venous thrombosis Dyspnea 030228 respiratory system Pneumothorax medicine.vein Cohort Emergency Medicine Female Differential diagnosis Emergency Service Hospital business |
| Zdroj: | The American Journal of Emergency Medicine. 34:386-391 |
| ISSN: | 0735-6757 |
| DOI: | 10.1016/j.ajem.2015.11.006 |
| Popis: | Objective The BRIPPED scan is an ultrasound evaluation of pulmonary B-lines, right ventricle size, inferior vena cava collapsibility, pleural and pericardial effusion, pneumothorax, left ventricle ejection fraction, and lower extremity deep venous thrombosis. The primary goal was to evaluate the effect of the BRIPPED scan on the physician's list of differential diagnoses for patients presenting with shortness of breath. Methods This prospective randomized control trial was performed on patients presenting to the emergency department with shortness of breath. Primary data analysis was performed using an ordinal quasi-symmetry model to compare the magnitude of change in the differential diagnoses between 2 groups. Secondary outcome measures included changes in physician orders or interventions, time to disposition, time to perform the BRIPPED scan, and the interrater reliability of the interpretation of the scan. Results A total of 104 patients and 24 physicians were enrolled in this study. Fifty-two patients were randomly assigned to each cohort. Among the BRIPPED cohort, there was significant movement of likelihood for several etiologies of shortness of breath on the physician differential. There was no significance in the change of differential diagnosis between the BRIPPED and control cohorts. The average (SD) time to perform the scan was 5.7 (1.3) minutes (95% confidence interval, 5.4-6 minutes). Conclusion The BRIPPED scan is a rapid ultrasound evaluation of shortness of breath in the emergency department. BRIPPED influenced physician differential diagnoses to the same degree as laboratory and radiographic testing. BRIPPED did not alter the final diagnosis in this patient population. |
| Databáze: | OpenAIRE |
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