Format

Send to

Choose Destination
J Emerg Trauma Shock. 2019 Jan-Mar;12(1):10-17. doi: 10.4103/JETS.JETS_61_18.

Utility of Point-of-Care Ultrasound in Differentiating Causes of Shock in Resource-Limited Setup.

Author information

1
Department of Emergency Medicine, Medical College and SSG Hospital, Vadodara, Gujarat, India.
2
Department of Preventive and Social Medicine, Medical College and SSG Hospital, Vadodara, Gujarat, India.

Abstract

Background:

Delivering early diagnosis of shock in resource-limited setting is challenging, especially with limited availability of point-of-care laboratory and radiological diagnostic facilities. There is growing urgency to provide point-of-care diagnosis and treatment for time-sensitive condition like shock.

Aims:

We tried to evaluate the application of point-of-care ultrasound (Rapid Ultrasound for Shock and Hypertension [RUSH] protocol) considering different disease cohort and practice realities in our setup.

Settings and Design:

This study was a single-center prospective diagnostic study to check the diagnostic accuracy of point-of-care ultrasound (RUSH protocol). This study was approved by the ethics committee.

Materials and Methods:

The study was conducted at the emergency medicine department of a tertiary care government hospital in Central Gujarat from November 16 to October 17. All adult patients with clinical features of shock with systolic blood pressure <90 mmHg and shock index >1 presenting to emergency department were included as participants. The results of point-of-care ultrasound (RUSH protocol) were compared with the diagnosis given by consultants of respective department as per standard departmental practices.

Statistical Analysis and Results:

A total of 130 patients were enrolled in this study. Mean time taken to examine by the point-of-care Ultrasound (RUSH protocol) was 12 min (range 11-14 min). Kappa index was 0.860. This protocol was able to correctly diagnose 100% of obstructive shock, 96.3% of cardiogenic shock, 94.4% of hypovolemic shock, 80.9% of mixed type of shock, and 75% of distributive type of shock.

Conclusion:

This study highlights the role of point-of-care ultrasound (RUSH protocol) for early diagnosis of the shock etiology in emergency medicine department. Diagnosis using point-of-care ultrasound (RUSH protocol) significantly agreed with medical diagnosis. It showed good efficacy of point-of-care ultrasound (RUSH protocol) to differentiate causes of shock with good accuracy except distributive shock.

KEYWORDS:

Emergency medicine; Rapid Ultrasound for Shock and Hypertension protocol; point-of-care ultrasound; shock

Supplemental Content

Full text links

Icon for PubMed Central
Loading ...
Support Center