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POCUS trial

POCUS trial. HEFTEMCAST. USS in Cardiac Arrest. M eta analysis from Blyth 2012 showed; Cardiaic motility as a predictor of ROSC P ositive likelihood ratio 4.26 (95% CI = 2.63 to 6.92), N egative likelihood ratio was 0.18. the paper.

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POCUS trial

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  1. POCUS trial HEFTEMCAST

  2. USS in Cardiac Arrest Meta analysis from Blyth 2012 showed; Cardiaic motility as a predictor of ROSC Positive likelihood ratio 4.26 (95% CI = 2.63 to 6.92), Negative likelihood ratio was 0.18

  3. the paper Laursen, Christian B., et al. "Point-of-care ultrasonography in patients admitted with respiratory symptoms: a single-blind, randomised controlled trial." The Lancet Respiratory Medicine (2014). The POCUS trial

  4. PAtients Prospective RCT Single centrehospital, Denmark Inclusion criteria RR > 20 bpm, SpO2 < 95%, commenced on O2 therapy Description of current/previous dyspnoea/cough/chest pain were screened for eligibility Exclusion criteria Mental disability, < 18 years of age, point of care USS not performed with 1 hr after the primary assessment

  5. Intervention Control group had a standard diagnostic work up POC group had the standard work up + USS of heart and lungs and deep veins in the legs The results of the USS were communicated to the clinician providing clinical care for the patient to inform their diagnostics and management plan

  6. Comparison Compared diagnosis at 4hrs matched with the discharge diagnosis

  7. Outcome Correct diagnosis 88% (POC) vs 64% (control) p-value <0.0001

  8. Referneces • VidakovikR, Feringa HH, Kuiper RJ, Karagiannis SE, Schouten O, Dunkelgrun M, Hoeks SE, Bom N, Bax JJ, Neskovic AN, Poldermans D. Comparison with computed tomography of two ultrasound devices for diagnosis of abdominal aortic aneurysm. Am J Cardiol2007 Dec15;100 (12):1786 91. • Dent B, Kendall RJ, Boyle AA, Atkinson PR. Emergency ultrasound of the abdominal aorta by UK emergency physicians: a prospective cohort study. Emerg Med J. 2007 Aug;24(8):547-9. • Taval VS, Graf CD, Gibbs MA. Prospective study of accuracy and outcome of emergency ultrasound for aortic aneurysm over two years. AcadEmerg Med. 2003 Aug;10(8):867-71 • Blyth, L., Atkinson, P., Gadd, K. and Lang, E. (2012), Bedside Focused Echocardiography as Predictor of Survival in Cardiac Arrest Patients: A Systematic Review. Academic Emergency Medicine, 19: 1119–1126.

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