title: Decreasing length of stay with emergency ultrasound examination of the gallbladder.
abstract: OBJECTIVE
  To determine whether patients who received emergency screening ultrasound examinations (ESUEs) of the gallbladder by emergency physicians (EPs) have a shorter ED length of stay (LOS) than do those receiving ultrasound studies from radiology.
  
  
  METHODS
  A retrospective chart review from July 1995 to August 1998 identified 1,242 patients who received gallbladder ultrasound examinations. Seven hundred fifty-three patients received ESUEs by EPs of varying levels of ultrasound experience. Four hundred eighty-nine patients received gallbladder ultrasound examinations from radiology, and were not scanned by EPs. The LOSs of the two groups were compared. Significance was evaluated using a two-tailed t-test.
  
  
  RESULTS
  When patients received an ESUE by an EP, the median LOS was 7% (22 min) less than that for those who received an ultrasound examination by radiology (p = 0.017; 95% CI = 4 min to 41 min). When evaluated by disposition, patients discharged home and scanned by EPs had their median LOSs shortened by 11% or 32 minutes (p = 0.02; 95% CI = 5 min to 55 min). When evaluated by time of day, patients who presented after hours (6 PM-6 AM) and were scanned by EPs spent 15% (52 min) less time in the ED (p = 0.0002; 95% CI = 26 min to 89 min). Those who were seen after hours and discharged home had their LOSs shortened by 20% (1 hr, 13 min, p = 0.001; 95% CI = 28 min to 1 hr, 56 min).
  
  
  CONCLUSIONS
  In a teaching hospital with a residency program, ESUEs decrease ED LOS for these patients. The difference was most apparent for patients presenting after hours.
authors.affiliation: Department of Emergency Medicine, Christ Hospital and Medical Center, Oak Lawn, IL 60453-2600, USA. blaivas@pyro.net
authors.forename: M
authors.initials: M
authors.lastname: Blaivas
authors.forename: R A
authors.initials: RA
authors.lastname: Harwood
authors.forename: M J
authors.initials: MJ
authors.lastname: Lambert
mesh_terms: D004632:Emergency Medical Services / Q000706:statistics & numerical data*; D005704:Gallbladder / Q000000981:diagnostic imaging*; D005705:Gallbladder Diseases / Q000000981:diagnostic imaging; D006801:Humans; D007902:Length of Stay; D012189:Retrospective Studies; D013995:Time; D014463:Ultrasonography