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Introduction and Objective: This study aimed to reveal the effect of classical triage and Bedside Focused Ultrasonography (POCUS) in addition to classical triage on diagnosis, treatment, emergency department follow-up and its relationship with triage models in patients presenting to the emergency department with abdominal pain complaints.
METHOD: This randomized, controlled, prospective study was conducted with a total of 262 volunteer participants who were divided into two groups as 127 classical triage and 135 POCUS in addition to classical triage with non-traumatic abdominal pain. The decision of which participant would be included in which group was made at a 1:1 ratio using a computer-aided randomization table. The researcher did not intervene in the clinical processes in any way. In this study, the effect of POCUS application performed in addition to classical triage on clinical processes (imaging request, initial analgesia administration time, consultation request, emergency department stay and outcome) in the primary outcome and on triage systems in the secondary outcome were evaluated. IBM SPSS 21.0 software was used for statistical analysis of the data.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| POCUS Triage | Experimental | Patients are directed to the area where they will be examined in accordance with the triage category determined by abdominal POCUS, which is performed in addition to classical triage. |
|
| Classical Triage | No Intervention | Patients are directed to the area where they will be examined in accordance with the triage category determined by classical triage application. |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Point of care ultrasound (POCUS) | Other | In this study, POCUS was performed by the same emergency medicine physician who had basic and advanced USG training and at least two years of POCUS experience, in accordance with ACEP imaging protocols. A portable USG device with B-Mode, M-Mode, Color Doppler, Power Doppler, Pulsed Wave Doppler modes, and which can be used in all clinical modes with a single probe was used during the protocol application (Butterfly iQ+â„¢, Burlington, United States). Eight abdominal points (epigastric region, right upper quadrant, right side, right lower quadrant, suprapubic region, left lower quadrant, left side and upper quadrant, umbilical region) were scanned with POCUS, the findings were recorded on the previously prepared form, the triage categories of the patients (cl) were updated and the patients were directed to the area where they would be examined with the form. |
| Measure | Description | Time Frame |
|---|---|---|
| Time to initial analgesia | To evaluate the effect of adding the POCUS application to conventional triage on clinical processes, including imaging requests, time to initial analgesia. | 6 months |
| Request for additional medical imaging | To evaluate the effect of adding the POCUS application to conventional triage on imaging requests. | 6 months |
| Emergency department length of stay | To evaluate the effect of adding POCUS to conventional triage on the length of stay of patients in the emergency department. | 6 months |
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| Measure | Description | Time Frame |
|---|---|---|
| POCUS diagnostic sensitivity | To determine the diagnostic sensitivity of POCUS performed during triage using the final reports of patients who requested imaging. | 6 months |
| Emergency severity index Outcome Measure |
Inclusion Criteria:
Exclusion Criteria:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Sakarya Training and Research Hospital | Sakarya | Adapazarı | 54100 | Turkey (Türkiye) |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 23283267 | Result | Thamburaj R, Sivitz A. Does the use of bedside pelvic ultrasound decrease length of stay in the emergency department? Pediatr Emerg Care. 2013 Jan;29(1):67-70. doi: 10.1097/PEC.0b013e31827b53f9. | |
| 33397050 | Result | Guner NG, Yurumez Y, Yucel M, Alacam M, Guner ST, Ercan B. Effects of Point-of-care Ultrasonography on the Diagnostic Process of Patients Admitted to the Emergency Department with Chest Pain: A Randomised Controlled Trial. J Coll Physicians Surg Pak. 2020 Dec;30(12):1262-1268. doi: 10.29271/jcpsp.2020.12.1262. |
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| ID | Term |
|---|---|
| D015746 | Abdominal Pain |
| D004630 | Emergencies |
| ID | Term |
|---|---|
| D010146 | Pain |
| D009461 | Neurologic Manifestations |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |
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|
To examine the categorization changes after POCUS with the emergency severity index before POCUS application.
| 6 months |
| Manchester Triage System Outcome Measure | To examine the categorization changes after POCUS with Manchester triage system before POCUS application. | 6 months |
| 3-group triage system Outcome Measure | To examine the categorization changes after POCUS with 3-group triage system before POCUS application | 6 months |
| 36205268 | Result | Durgun Y, Yurumez Y, Guner NG, Aslan N, Durmus E, Kahraman Y. Abdominal Pain Management and Point-of-care Ultrasound in the Emergency Department: A Randomised, Prospective, Controlled Study. J Coll Physicians Surg Pak. 2022 Oct;32(10):1260-1265. doi: 10.29271/jcpsp.2022.10.1260. |
| D012817 | Signs and Symptoms, Digestive |
| D020969 | Disease Attributes |
| D010335 | Pathologic Processes |