A point-of-care thoracic ultrasound protocol for hospital medical emergency teams (METUS) improves diagnostic accuracy

• Published in: The ultrasound journal Vol. 13; no. 1; p. 29
• Main Authors: Blans, M. J, Bousie, E, van der Hoeven, J. G, Bosch, F. H
• Format: Journal Article
• Language: English
• Published: Cham Springer International Publishing 04-06-2021; Springer Nature B.V; SpringerOpen
• Subjects: Critical Care Medicine; Diagnosis; Diagnostic Radiology; Emergency medical services; Emergency Medicine; Health services; Imaging; Intensive; Interventional Radiology; Medical diagnosis; Medicine; Medicine & Public Health; Mortality; Original; Original Article; Point of care testing; Radiology; Teams; Ultrasonic imaging; Ultrasound; United States > US
• ISSN: 2524-8987; 2524-8987
• DOI: 10.1186/s13089-021-00229-3

Background
Point-of-care ultrasound (POCUS) has proven itself in many clinical situations. Few data on the use of POCUS during Medical Emergency Team (MET) calls exist. In this study, we hypothesized that the use of POCUS would increase the number of correct diagnosis made by the MET and increase MET’s certainty.
Methods
Single-center prospective observational study on adult patients in need for MET assistance. Patients were included in blocks (weeks). During even weeks, the MET physician performed a clinical assessment and registered an initial diagnosis. Subsequently, the POCUS protocol was performed and a second diagnosis was registered (US+). During uneven weeks, no POCUS was performed (US−). A blinded expert reviewed the charts for a final diagnosis. The number of correct diagnoses was compared to the final diagnosis between both groups. Physician’s certainty, mortality and possible differences in first treatment were also evaluated.
Results
We included 100 patients: 52 in the US + and 48 in the US−  group. There were significantly more correct diagnoses in the US+ group compared to the US− group: 78 vs 51% (
P
  = 0.006). Certainty improved significantly with POCUS (
P
  <  0.001). No differences in 28-day mortality and first treatment were found.
Conclusions
The use of thoracic POCUS during MET calls leads to better diagnosis and increases certainty.
Trial registration
. ClinicalTrials.gov. Registered 12 July 2017, NCT03214809
https://www.clinicaltrials.gov/ct2/show/NCT03214809?term=metus&cntry=NL&draw=2&rank=1