TY - JOUR
T1 - A prospective study of ultrasonography in the ED by emergency physicians
AU - Schlager, Dan
AU - Lazzareschi, Gerry
AU - Whitten, David
AU - Sanders, Arthur B.
N1 - Funding Information:
From the ‘Department of Emergency Medicine, Kaiser Perma-nente Medical Center, Santa Rosa, CA; and the TSection of Emergency Medicine, Department of Surgery, University of Ari-zona College of Medicine, Tucson, AZ. Manuscript received May 30, 1993; revision accepted October 11, 1993. This study was presented at the Society for Academic Emergency Medicine Annual Meeting, Toronto, Ontario, Canada, May 26 to 30, 1992. The research was supported in part by the Northern California Kaiser Foundation Health Plan, Inc, Community Service Program. Address reprint requests to Dr Schlager, 16 Barn Rd, Mill Valley, CA 94941. Key Words: Aortic aneurysm, emergency medicine, emergency service, hospital, pregnancy, ultrasonography. Copyright 0 1994 by W.B. Saunders Company 07356757/94/1202-0015$500/O
PY - 1994/3
Y1 - 1994/3
N2 - The objective of this study was to examine the use of limited, goal-directed, two-dimensional ultrasound studies performed by emergency physicians and to assess the frequency, variety, and accuracy of their readings. A 1-year prospective study was performed by using an emergency department (ED) ultrasound machine with a 3.5-mHz mechanical oscillating sector transducer and a 5.0-mHz vaginal transducer. In a series of proctoring sessions, radiologists trained emergency physicians to do limited, goal-directed ultrasonography. Laser print ultrasonograms were collected from all ED ultrasound examinations performed during a 1-year period and were compared with either formal ultrasonograms performed in the radiology department, the patient's hospital record, or both. Sensitivity, specificity, and positive predictive value (PPV), as well as negative predictive values (NPV), were calculated. The setting was a 104-bed community hospital with an ED volume of 25,000 patients annually, and patients whom the emergency physician belleved needed ultrasound studies in the ED were entered. ED ultrasonography was performed in 167 patients by 14 physicians during a 1-year period. For 132 patients who completed formal follow-up, the overall diagnostic accuracy of interpretations of ED ultrasonograms yielded a sensitivity of .95, specificity of .98, PPV of .99, and NPV of .89. Eleven categories of ultrasound use were reported. The three studies most commonly performed were for gallbladder disease (53%), intrauterine pregnancy (28%), and abdominal aortic aneurysms (7%). Accuracy of ED gallbladder ultrasonograms for 65 patients showed a sensitivity of .86, specificity of .97, PPV of .97, and NPV of .85. No false-positive or false-negative results were found for ED ultrasonography performed in 42 patients for intrauterine pregnancy or 11 patients for abdominal aortic aneurysms. With appropriate training, emergency physicians can perform diagnostic ultrasound studies with a high degree of accuracy.
AB - The objective of this study was to examine the use of limited, goal-directed, two-dimensional ultrasound studies performed by emergency physicians and to assess the frequency, variety, and accuracy of their readings. A 1-year prospective study was performed by using an emergency department (ED) ultrasound machine with a 3.5-mHz mechanical oscillating sector transducer and a 5.0-mHz vaginal transducer. In a series of proctoring sessions, radiologists trained emergency physicians to do limited, goal-directed ultrasonography. Laser print ultrasonograms were collected from all ED ultrasound examinations performed during a 1-year period and were compared with either formal ultrasonograms performed in the radiology department, the patient's hospital record, or both. Sensitivity, specificity, and positive predictive value (PPV), as well as negative predictive values (NPV), were calculated. The setting was a 104-bed community hospital with an ED volume of 25,000 patients annually, and patients whom the emergency physician belleved needed ultrasound studies in the ED were entered. ED ultrasonography was performed in 167 patients by 14 physicians during a 1-year period. For 132 patients who completed formal follow-up, the overall diagnostic accuracy of interpretations of ED ultrasonograms yielded a sensitivity of .95, specificity of .98, PPV of .99, and NPV of .89. Eleven categories of ultrasound use were reported. The three studies most commonly performed were for gallbladder disease (53%), intrauterine pregnancy (28%), and abdominal aortic aneurysms (7%). Accuracy of ED gallbladder ultrasonograms for 65 patients showed a sensitivity of .86, specificity of .97, PPV of .97, and NPV of .85. No false-positive or false-negative results were found for ED ultrasonography performed in 42 patients for intrauterine pregnancy or 11 patients for abdominal aortic aneurysms. With appropriate training, emergency physicians can perform diagnostic ultrasound studies with a high degree of accuracy.
KW - Aortic aneurysm
KW - emergency medicine
KW - emergency service
KW - hospital
KW - pregnancy
KW - ultrasonography
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U2 - 10.1016/0735-6757(94)90244-5
DO - 10.1016/0735-6757(94)90244-5
M3 - Article
C2 - 8161394
AN - SCOPUS:0028289409
SN - 0735-6757
VL - 12
SP - 185
EP - 189
JO - American Journal of Emergency Medicine
JF - American Journal of Emergency Medicine
IS - 2
ER -