Patient time in emergency departments could be halved if doctors working there were trained to carry out ultrasound on patients with suspected deep vein thrombosis (DVT), a major conference has heard.
Dr Ossi Hannula, an emergency medicine specialist at the Wellbeing Services County of Central Finland, told delegates at the European Emergency Medicine Congress it could mean the difference of more than two hours, helping to reduce overcrowding in emergency departments.
He said: “Prolonged stays in emergency departments are linked to emergency department crowding.
“The longer a patient stays in an emergency department, the higher are the death rates and the risks of other complications, the longer their stay in a hospital ward, the lower the patient satisfaction, and the higher the financial costs and the burden on emergency department staff.”
Dr Hannula’s earlier studies had shown that if GPs in primary care were taught to perform ultrasound scans on patients with suspected DVT, they referred fewer patients to hospital emergency departments.
He then decided to see if ultrasound performed by emergency physicians instead of radiographers and radiologists could reduce the time patients spent in emergency departments.
For this study, 93 patients with a suspected DVT in two Finnish hospitals – Tampere University Hospital and Kuopio University Hospital – were recruited between October 2017 and October 2019.
They were included in the study if an emergency doctor who had been trained to perform ultrasound scans examined them and performed point-of-care ultrasound (POCUS).
Eleven emergency medicine specialists and junior doctors in the two hospitals examined the patients in the study. Dr Hannula compared the results with a control group of 135 patients who arrived in the same emergency departments with suspected DVT on the same days but were sent for ultrasound scans in the hospitals’ imaging departments.
“We found that patients undergoing the standard ultrasound examination spent an average of 4.51 hours in the emergency departments, while the group receiving point-of-care ultrasound spent an average of 2.34 hours in the emergency departments – a difference of 2.16 hours,” said Dr Hannula.
“The crowding in emergency departments is an increasing threat to patient safety as well as staff wellbeing. Using point-of-care ultrasound is one way of tackling this threat by reducing an unnecessary delay in decision making.”
Source:
Hannula O (2023) “Abstract OA89: Emergency physician performed point-of-care ultrasound on patients suspected of deep venous thrombosis reduces length of stay in emergency department: a prospective multicentre study”, presentation at European Emergency Medicine Congress, Barcelona, Spain, Monday 18 September.
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