Impact and Appropriateness of the Emergency
Ultrasonography in a Tertiary Care Hospital
Bussanee Wibulpolprasert MD*,
Cholatip Wiratkapun MD*, Janjira Jatchavala MD*,
Nittakarn Suraseepat MD*, Panuwat Lertsithichai MD, MSc**
Affiliation :
* Department of Radiology, the Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
** Department of Surgery, the Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
Objective : To quantify the notion of the impact of ultrasonography (US) on and the appropriateness of its use in, the diagnosis
and treatment of emergency conditions.
Material and Method: A prospective study was conducted between September 2006 and April 2007 at a tertiary care hospital.
US was performed or supervised by experienced staff radiologists during the working hours and by final year radiology
residents during the off-hours. Data collection forms were filled by radiology residents. The final discharge diagnoses were
obtained from medical charts and computerized records. Data collected included age, gender, provisional diagnosis, ultrasound
findings, the discharge diagnosis, time of ultrasound examination, other radiologic investigations and therapeutic interventions.
Outcomes included the impact, appropriateness, and diagnostic accuracy of US.
Results : Six hundred eighteen patients underwent 702 emergency ultrasound examinations. The median age was 51 years.
Approximately 50% were male. The anatomical region most commonly examined was the abdomen (80%). US had an impact
on clinical management in 85% of all examinations. Appropriate use of US was seen in 64% of all examinations. The overall
accuracy of US was 90%. Factors associated with higher impact included suspected urological, vascular and musculoskeletal
conditions, while vague abdominal conditions were associated with less impact.
Conclusion : The impact of US on the management of emergency conditions was high and most requests for US were
appropriate. However, a more efficient use of emergency US is still possible, especially for abdominal conditions.
Keywords : Impact, Appropriate use, Emergency, Ultrasound
All Articles
Download