0
Critical Care |

Accuracy of Interpretation of Point of Care Ultrasound Images in Critically Ill Patients via Telemedicine FREE TO VIEW

Gulrukh Zaidi, MD; Sean Dhar, MD; Lisa Chen, DO; Saurabh Chandra, MD; Seth Koenig, MD
Author and Funding Information

North Shore LIJ Health System, Hofstra School of Medicine, New Hyde Park, NY


Chest. 2015;148(4_MeetingAbstracts):331A. doi:10.1378/chest.2250563
Text Size: A A A
Published online

Abstract

SESSION TITLE: Pulmonary & Critical Care Imaging

SESSION TYPE: Original Investigation Slide

PRESENTED ON: Tuesday, October 27, 2015 at 11:00 AM - 12:15 PM

PURPOSE: Point of care ultrasound (PCUS) enables accurate assessment and monitoring of critically ill patients, decreasing the need for patient mobilization and radiologic studies. The interpretation of PCUS images by a tele-ICU physician has not been studied. Our study attempts to establish the feasibilty of interpretation of PCUS exams by tele-ICU physicians.

METHODS: Thoracic, cardiac and lower extremity PCUS was performed by an intensivist on 18 patients in a community hospital’s medical/surgical ICU. All ICU and tele-ICU physicians were trained in critical care ultrasonography. Independent real time interpretation of the ultrasound images by the bedside intensivist and the tele-ICU physician were compared. The recorded images were also interpreted by a third critical care physician blinded to the patient and interpretation by the tele-ICU.

RESULTS: A total of 18 lung and focused cardiac exams as well as 16 lower extremity compression ultrasound (le-CUS) studies were performed. Video quality was adequate for the tele-ICU physician to visualize the ultrasound screen through the camera while studies were being performed. 6 thoracic, 10 cardiac and 10 le-CUS studies were read as normal. 12 thoracic, 8 cardiac, 6 le-CUS studies revealed a pathologic finding . Pathologic findings included B-lines,lung consolidation, pleural effusions, pericardial effusions, reduced left ventricular function with segmental wall motion abnormalities and deep venous thrombosis. A 100% concordance was seen in the image interpretation by the bedside intensivist and the tele-ICU physician. When the recorded video clips were reviewed by the third blinded intensivist the concordance on study results was also 100%.

CONCLUSIONS: A tele-ICU intensivist can accurately interpret PCUS images in critically ill patients.

CLINICAL IMPLICATIONS: PCUS can be used successfully by a tele-ICU intensivist in the assessment and monitoring of critically ill patients. This has special importance in ICUs without 24 hour in-house intensivist staffing. If bedside providers including advanced-care practitioners, residents and non-intensivist physicians staffing these units can be trained to adequately acquire PCUS images, a tele-ICU physician with critical care ultrasound training can accurately interpret these exams and use the results to guide patient management. Furthermore the critical care ultrasonography skills of tele-ICU physicians can be used to enhance PCUS training and monitor the progress of the practitioners responsible for image acquisition at bedside.

DISCLOSURE: The following authors have nothing to disclose: Gulrukh Zaidi, Sean Dhar, Lisa Chen, Saurabh Chandra, Seth Koenig

No Product/Research Disclosure Information


Figures

Tables

References

NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).

Some tools below are only available to our subscribers or users with an online account.

Related Content

Customize your page view by dragging & repositioning the boxes below.

Find Similar Articles
CHEST Journal Articles
  • CHEST Journal
    Print ISSN: 0012-3692
    Online ISSN: 1931-3543