title: Real-time B-mode ultrasound in the ED saves time in the diagnosis of deep vein thrombosis (DVT).
abstract: We hypothesize that EPs can decrease the time to disposition when performing examinations for deep venous thrombosis (DVT) compared with disposition times using imaging specialists (IS). We performed a prospective, single-blind observational study at an academic ED over the course of 1 year. Patients were enrolled based on study physician availability. EPs ordered the corroborative ultrasound, then performed their own examination. EPs recorded patient triage time, ED results, and disposition times for both EP and IS departments. One hundred fifty-six patients were enrolled. Thirty-four (22%) were diagnosed with a DVT. Mean time from triage to EP disposition was 95 minutes and mean time from triage to radiology disposition was 220 minutes. The difference of 125 minutes was statistically significant (P <.0001). EPs and ISs had excellent agreement (kappa = 0.9). Compression ultrasound performed by EPs resulted in a significant decreased time to disposition. Agreement with ISs was excellent.
authors.affiliation: Department of Emergency Medicine, North Shore university Hospital, Manhasset, New York, USA.
authors.forename: Daniel
authors.initials: D
authors.lastname: Theodoro
authors.forename: Michael
authors.initials: M
authors.lastname: Blaivas
authors.forename: Sandeep
authors.initials: S
authors.lastname: Duggal
authors.forename: Graham
authors.initials: G
authors.lastname: Snyder
authors.forename: Michael
authors.initials: M
authors.lastname: Lucas
mesh_terms: D015982:Bias; D002985:Clinical Protocols / Q000592:standards; D017598:Efficiency, Organizational; D004636:Emergency Service, Hospital / Q000458:organization & administration; D004638:Emergency Treatment / Q000379:methods / Q000592:standards; D005845:Georgia; D006302:Health Services Research; D006785:Hospitals, University; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D018579:Patient Selection; D019095:Point-of-Care Systems / Q000592:standards*; D011446:Prospective Studies; D011859:Radiography; D012449:Safety; D012680:Sensitivity and Specificity; D016037:Single-Blind Method; D013997:Time Factors; D014218:Triage / Q000379:methods / Q000592:standards; D018616:Ultrasonography, Doppler, Duplex / Q000379:methods / Q000592:standards; D020246:Venous Thrombosis / Q000000981:diagnostic imaging*