Infectious Disease

Use point-of-care ultrasound in conjunction with the standard procedure for acute dyspnea

April 26, 2021

1 min read

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Neither Fincher nor Qaseem report any relevant financial information. In the study you will find all relevant financial information from all other authors.

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The ACP has issued a new guideline recommending that clinicians use on-site ultrasound along with the standard diagnostic route for patients with acute dyspnea with diagnostic uncertainties in ED and in inpatient settings.

The standard diagnostic pathway for acute dyspnea includes taking a medical history, performing a physical exam, and requesting blood tests, chest or cardiac imaging, EKG, and other diagnostic tests.

Acute dyspnea is associated with more than 1 million ED visits annually, according to a press release from the organization.

The recommendation is intended to improve the diagnosis, treatment and health outcomes of patients with suspected heart failure, pneumonia, pulmonary embolism, pleural effusion or pneumothorax. This does not apply to handheld POCUS (point-of-care ultrasound) devices, which lack data on efficacy, potential harm, and diagnostic accuracy, according to ACP.

Studies have shown that POCUS, when used in addition to the standard diagnostic route, increased the proportion of accurate diagnoses by almost a third. Amir Qaseem, MD, PhD, MHA, The ACP Director of Clinical Policy and colleagues wrote in the Annals of Internal Medicine.

The recommendation is based on several factors including the accuracy of the sensitivity of POCUS when used in addition to standard diagnostic tests, the improbability of harm when using POCUS, and its low cost. However, the recommendation is conditional for a number of reasons, including the limited and uncertain evidence regarding the impact of POCUS on hospital stays, as well as the testing protocols and training related to its use, the researchers said.

“The appropriate use of POCUS in treating patients in these settings is an important issue for clinicians.” Jacqueline W. Fincher, MD, MACP, President of the AKP said in the press release. “As this diagnostic tool becomes increasingly popular, it is important to understand its benefits, potential harm, and best use as an accurate diagnostic tool.”

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