FOCUS may lower PE diagnosis in ED patients with suspected PE and abnormal vitals
Credit: Josh Lupton, MD, Oregon Health & Science University and resident editor, Academic Emergency Medicine journal
DES PLAINES, IL — Focused cardiac ultrasound (FOCUS) performed by emergency physicians with advanced training in emergency ultrasound may significantly lower the likelihood of the diagnosis of pulmonary embolism (PE) in most patients who are suspected of PE and have abnormal vital signs. This was especially true in those patients with a heart rate > 110 beats/min. That is the conclusion of a study to be published in the November 2019 issue of Academic Emergency Medicine (AEM), a journal of the Society for Academic Emergency Medicine (SAEM).
The lead author of the prospective observational multicenter cohort study is James I. Daley MD, MS, MPH, an instructor in the Department of Emergency Medicine at Yale School of Medicine. Daley et. al suggest that further study in a larger cohort of patients (which would yield narrower 95% confidence intervals) is required before focused cardiac ultrasound can be used to reliably exclude pulmonary embolism in this patient population.
The results suggest that FOCUS can be an important tool in the initial evaluation of emergency department (ED) patients with suspected PE and abnormal vital signs.
Commenting on the study is Robert R. Ehrman, MD, MS, the director of emergency ultrasound research at Wayne State University School of Medicine/Detroit Medical Center in Detroit, MI:
“This is an important study as it is the first to demonstrate that point-of-care echocardiography can meaningfully reduce the likelihood of pulmonary embolism when clinical suspicion is high, potentially obviating the need for CT scanning in some patients. Moreover, the skills required to perform this exam are within the scope of all Emergency Physicians and thus the potential benefits at the population level are immense.”
ABOUT ACADEMIC EMERGENCY MEDICINE
Academic Emergency Medicine, the monthly journal of Society for Academic Emergency Medicine, features the best in peer-reviewed, cutting-edge original research relevant to the practice and investigation of emergency care. The above study is published open access and can be downloaded by following the DOI link: 10.1111/acem.13774. Journalists wishing to interview the authors may contact Stacey Roseen at [email protected]
ABOUT THE SOCIETY FOR ACADEMIC EMERGENCY MEDICINE
SAEM is a 501(c)(3) not-for-profit organization dedicated to the improvement of care of the acutely ill and injured patient by leading the advancement of academic emergency medicine through education and research, advocacy, and professional development. To learn more, visit saem.org.
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