PMID- 23995666
OWN - NLM
STAT- MEDLINE
DCOM- 20150420
LR  - 20220330
IS  - 1473-5695 (Electronic)
IS  - 0969-9546 (Linking)
VI  - 21
IP  - 4
DP  - 2014 Aug
TI  - Emergency department led emergency ultrasound may improve the time to diagnosis 
      in patients presenting with a ruptured abdominal aortic aneurysm.
PG  - 272-5
LID - 10.1097/MEJ.0000000000000077 [doi]
AB  - OBJECTIVES: Does emergency ultrasound (EU) improve the speed of diagnosis of 
      patients presenting to the emergency department (ED) with a ruptured abdominal 
      aortic aneurysm (rAAA)? METHODS: This is a retrospective study of all patients 
      presenting to the ED of the Royal Infirmary of Edinburgh (RIE) with an rAAA. The 
      RIE surgical database and the RIE ED registry of emergency-based ultrasound scans 
      were assessed and time to diagnose rAAA was compared for the periods before and 
      after the introduction of EU, as well as for rAAA patients who underwent EU and 
      those who did not. Patients with known AAA and those transferred from another 
      hospital with known or suspected rAAA were excluded. RESULTS: Between 27 December 
      2006 and 13 January 2009, before the establishment of our EU programme, 65 
      patients presented to the ED of RIE with an rAAA. The median time to diagnosis 
      was 95 min [interquartile range (IQR) 41-195 min; n=30]. Between 14 January 2009 
      and 15 February 2012, after the establishment of our EU programme, 54 patients 
      presented to the ED of RIE with an rAAA. The median time to diagnosis was 64 min 
      (IQR 31-140 min; n=28; Z=0.95, P=0.3421). Eighteen out of the 28 patients with 
      rAAA underwent EU; the median time to diagnosis was 60 min (IQR 27-115 min; 
      n=18). Of the patients with rAAA, 35 did not undergo EU; the median time to 
      diagnosis was 111 min (IQR 45-213 min; n=35; Z=-1.69, P=0.091). There was no 
      improvement in survival between patients who underwent an ED EU and those who did 
      not (P=0.40). CONCLUSION: There was a nonsignificant trend towards a faster time 
      to diagnosis (51 min) in rAAA patients who underwent EU on presenting to the ED 
      compared with those who did not undergo an ED EU (111 min). There was no 
      improvement in survival or length of ICU unit stay.
FAU - Reed, Matthew J
AU  - Reed MJ
AD  - aCollege of Medicine and Veterinary Medicine, University of Edinburgh bEmergency 
      Medicine Research Group Edinburgh (EMeRGE), Department of Emergency Medicine, 
      Royal Infirmary of Edinburgh, Edinburgh, UK.
FAU - Cheung, Lai-Ting
AU  - Cheung LT
LA  - eng
PT  - Journal Article
PL  - England
TA  - Eur J Emerg Med
JT  - European journal of emergency medicine : official journal of the European Society 
      for Emergency Medicine
JID - 9442482
SB  - IM
MH  - Aortic Aneurysm, Abdominal/diagnosis/*diagnostic imaging/mortality
MH  - Aortic Rupture/diagnosis/*diagnostic imaging/mortality
MH  - *Emergency Service, Hospital/statistics & numerical data
MH  - Humans
MH  - Intensive Care Units/statistics & numerical data
MH  - Length of Stay/statistics & numerical data
MH  - Retrospective Studies
MH  - Time Factors
MH  - Ultrasonography
EDAT- 2013/09/03 06:00
MHDA- 2015/04/22 06:00
CRDT- 2013/09/03 06:00
PHST- 2013/09/03 06:00 [entrez]
PHST- 2013/09/03 06:00 [pubmed]
PHST- 2015/04/22 06:00 [medline]
AID - 10.1097/MEJ.0000000000000077 [doi]
PST - ppublish
SO  - Eur J Emerg Med. 2014 Aug;21(4):272-5. doi: 10.1097/MEJ.0000000000000077.