Journal review
Kuhn M, Bonnin RL, Davey MJ, et al. Emergency department ultrasound scanning for abdominal aortic aneurysm: Accessible, accurate, and advantageous. Ann Emerg Med 2000; 36:219-223.
Even ED physicians with limited training can accurately identify the presence or absence of abdominal aortic aneurysms (AAAs) with bedside ultrasound scanning, says this study from Royal Adelaide Hospital in Australia. The aortic ultrasound scans are a useful screening tool for high-risk ED patients and also rapidly verify the diagnosis in patients who might need immediate surgical intervention.
Patients with suspected AAAs had ultrasound scanning by an ED physician. Of 68 scans, 26 were positive, 40 were negative, and two were indeterminate. The scan interpretations were 100% accurate. The potential impact of the ED scans was ascertained by comparing the pre-ultrasound and post-ultrasound assessment plans. The study found the ED scans would have improved the care of 46 patients and would not have adversely affected any patient.
In patients with AAAs, the ultrasound examinations appeared to benefit all aspects of patient care: improving diagnostic accuracy, eliminating additional investigations, improving treatment decisions, and expediting the patients’ transfer to surgery.
The researchers argue performance of bedside aortic scans by ED physicians instead of ultrasonographers might ensure 24-hour availability of this service. They write: "We believe that bedside aortic scans by emergency physicians will have a significant impact on patient care and should be incorporated into the standard management of patients older than 50 years of age who present with abdominal/back pain."
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