American Journal of Emergency Medicine
Volume 24, Issue 7 , Pages 782-786, November 2006

Emergency ultrasound evaluation of symptomatic nontraumatic pleural effusions

  • Vivek S. Tayal, MD

      Affiliations

    • Department of Emergency Medicine, Carolinas Medical Center, Charlotte, NC 28232, USA
    • Corresponding Author InformationCorresponding author. Tel.: +1 704 366 0060.
    • ,
  • Bret A. Nicks, MD

      Affiliations

    • Department of Emergency Medicine, Carolinas Medical Center, Charlotte, NC 28232, USA
    • Currently at the Department of Emergency Medicine, Wake Forest University School of Medicine, Winston-Salem, NC.
    • ,
  • H. James Norton, PhD

      Affiliations

    • Department of Biostatistics, Carolinas Medical Center, Charlotte, NC 28232, USA

Received 26 January 2006; received in revised form 9 March 2006; accepted 10 March 2006.

Abstract 

Objective

We hypothesized that thoracic ultrasound (ThorUS) performed by emergency physicians would be a rapid and effective management tool for the evaluation of nontraumatic pleural effusion (PleurEff).

Methods

This is a prospective observational study of symptomatic adults presenting to an urban ED with suspicion of PleurEff. ThorUS was performed bilaterally in the upright position. Measurements included treating physician's procedural time requirements, pre- and posttest likelihood of PleurEff, and management changes.

Results

There were 59 patients who were entered into the study. Investigating physician's actual time to perform ThorUS was 2.19 minutes. After ThorUS, 48 (81%) patients had an increase and 11 (19%) had a reduction in likelihood of PleurEff with average absolute change in likelihood of PleurEff of 34% (P < .02). ThorUS changed management in 41% of cases; thoracentesis occurred most frequently.

Conclusion

ThorUS performed by emergency physicians is a rapid and effective management tool for the evaluation of nontraumatic PleurEff in symptomatic ED patients.

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 Presented at the 2004 ACEP Research Forum in San Francisco, Calif.

PII: S0735-6757(06)00104-5

doi:10.1016/j.ajem.2006.03.017

American Journal of Emergency Medicine
Volume 24, Issue 7 , Pages 782-786, November 2006

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