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J Ultrasound Med. 2019 Apr 1. doi: 10.1002/jum.14993. [Epub ahead of print]

Reliability of Neck Mass Point-of-Care Ultrasound by Pediatric Emergency Physicians.

Author information

1
Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
2
Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada.
3
Safra Children's Hospital, Sheba Medical Center, Tel Hashomer, Israel.

Abstract

OBJECTIVES:

Neck masses are a common reason for presentations to the pediatric emergency department (PED). We sought to determine the agreement and time difference between point-of-care ultrasound (POCUS) imaging by pediatric emergency physicians compared to radiology department imaging for children with neck masses in the PED.

METHODS:

We performed a retrospective study of patients aged 0 to 18 years presenting to our tertiary PED who received both POCUS by a pediatric emergency physician and radiology department imaging. Charts were reviewed for POCUS diagnoses, final diagnoses, and imaging time metrics.

RESULTS:

Seventy-five patients met the study criteria. In 58 of 75 cases there was agreement between the POCUS diagnosis and final diagnosis (κ = 0.71; 95% confidence interval, 0.6-0.83). There was agreement in 25 of the 28 cases in which POCUS examinations were performed by PED physicians with fellowship training in POCUS (κ = 0.87; 95% confidence interval, 0.72-1.00). The results for POCUS were generated in a median of 115 minutes (interquartile range, 68-185 minutes) before radiology department imaging results.

CONCLUSIONS:

Point-of-care ultrasound imaging by pediatric emergency physicians for children with neck masses is a promising new POCUS application that may be able to save time in the PED.

KEYWORDS:

neck mass; pediatric emergency medicine; point-of-care ultrasound

PMID:
30937939
DOI:
10.1002/jum.14993

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