Education, Research, and Quality Improvement: Education and Quality Improvement |

Clinical Impact of Point of Care Ultrasound (POCUS) Consult Service in a Teaching Hospital: Effect on Diagnoses and Cost Savings FREE TO VIEW

Thatcher Jones, MD; Poh Leng, MD
Author and Funding Information

Legacy, Portland, OR

Copyright 2016, American College of Chest Physicians. All Rights Reserved.

Chest. 2016;149(4_S):A236. doi:10.1016/j.chest.2016.02.245
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SESSION TITLE: Education and Quality Improvement

SESSION TYPE: Original Investigation Poster

PRESENTED ON: Saturday, April 16, 2016 at 11:45 AM - 12:45 PM

PURPOSE: The use of point of care ultrasound (POCUS) to guide clinical diagnosis and treatment decisions has been growing as its accuracy and accessibility continue to improve. The aim of this study is to determine the clinical usefulness of a POCUS consult service in answering specific clinical questions to guide investigation and management.

METHODS: Over an 8 month period, 50 patients were consulted, mainly with diagnoses of hypoxia or shock. POCUS exams were performed according to BLUE and RUSH protocol. Exams were performed in the ICU, medicine floors and ED. Clinical information from POCUS exam was shared with the consulting team and these findings were used to make clinical and treatment decisions, where appropriate. Congruency bewteen ultrasound diagnosis and final chart diagnosis was recorded. The clincal action guided by ultrasound was tracked.

RESULTS: The majority of patients were enrolled in the ICU, 12% on the general medical floor, 2% in the ED. POCUS exam demonstrated 80% congruency with the final diagnosis. Of the 20% that were incongruous, US examination provided additional diagnostic information allowing a treatment decision to be made 80% of the time. In only 4% of cases was US unable to provide additional clinical benefit. The most common clinical actions aided by the exam included, fluid resuscitation 35%, pressor alteration 17% and diuresis 12%. The total extrapolated cost savings from potential diagnostic testing totaled over $80,000.

CONCLUSIONS: The use of a directed POCUS consult is accurate and is able to guide clinical decision making. Additionally, there is a potential for significant cost savings and utilization outside the ED and ICU settings.

CLINICAL IMPLICATIONS: POCUS consults can aide physician’s treatment decisions in the ICU and regular medicine floors when conventional imaging and work up does not demonstrate a clear diagnosis.

DISCLOSURE: The following authors have nothing to disclose: Thatcher Jones, Poh Leng

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