28 research outputs found
Evaluation of a point-of-care ultrasound scan list in a resource-limited emergency centre in Addis Ababa Ethiopia
Introduction: Emergency centres (EC) in low- and middle-income countries often have limited diagnostic imaging capabilities. Point-of-care ultrasound (POCUS) is used in high-income countries to diagnose and guide treatment of life-threatening conditions. This study aims to identify high impact POCUS scans most relevant to practice in an Ethiopian EC.
Methods: A prospective observational study where patients presenting to Tikur Anbessa Specialized Hospital EC in Addis Ababa were eligible for inclusion. Physicians referred patients with a clinical indication for POCUS from a pre-determined 15-scan list. Scans were performed and interpreted, at the bedside, by qualified emergency physicians with POCUS training.
Results: A convenience sample of 118 patients with clinical indications for POCUS was enrolled. The mean age was 35 years and 42% were female. In total, 338 scans were performed for 145 indications in 118 patients. The most common scans performed were pericardial (n = 78; 23%), abdominal free fluid (n = 73; 22%), pleural effusion/haemothorax (n = 51; 15%), inferior vena cava (n = 43; 13%), pneumothorax (n = 38; 11%), and global cardiac activity (n = 25; 7%). One hundred and twelve (95%) POCUS scans provided clinically useful information. In 53 (45%) patients, ultrasound findings changed patient management plans by altering the working diagnosis (n = 32; 27%), resulting in a new treatment intervention (n = 28; 24%), resulting in a procedure/surgical intervention (n = 17; 14%) leading to consultation with a specialist (n = 16; 14%), and/or changing a disposition decision (n = 9; 8%).
Discussion: In this urban, low-resource, academic EC in Ethiopia, POCUS provided clinically relevant information for patient management, particularly for polytrauma, undifferentiated shock and undifferentiated dyspnea. Results have subsequently been used to develop a locally relevant emergency department ultrasound curriculum for Ethiopia’s first emergency medicine residency program
Predefined drop-down menu of COVID-19 related diagnoses allocated to the hospitalized primarily for COVID-19 category.
Predefined drop-down menu of COVID-19 related diagnoses allocated to the hospitalized primarily for COVID-19 category.</p
Factors associated with ventilation, critical care admission or mortality among 1,651 SARS-CoV-2 positive patients, according to the CDC admission classification.
OR = odds ratio; ICU = intensive care unit; CI = confidence interval. a active malignant neoplasm, transplant recipient, moderate/severe liver disease. Hospital site was included as a fixed effect in this model. For simplicity, site estimates were excluded from the table. (DOCX)</p
Contributors to the Canadian COVID-19 Emergency Department Rapid Response Network.
Contributors to the Canadian COVID-19 Emergency Department Rapid Response Network.</p
The most common primary discharge diagnoses among discordant cases when comparing the clinical decision and the Massachusetts method of classification.
The most common primary discharge diagnoses among discordant cases when comparing the clinical decision and the Massachusetts method of classification.</p
Hospital sites and dates of consecutive data entry.
Hospital sites and dates of consecutive data entry.</p
Probability of most common uncertain discharge diagnoses being categorized primarily for COVID-19.
The x-axis depicts the probability of being adjudicated by clinicians as an admission primarily for COVID-19 among all cases with the same primary discharge diagnosis that were abstracted from the medical record. (DOCX)</p
Patient and presentation characteristics by admission status using clinician decision.
Patient and presentation characteristics by admission status using clinician decision.</p