Diagnostic Value Of Bedside Ultrasound For Emergency Department Physicians In Acute Dyspnea

Objective: To investigate the diagnostic value of bedside ultrasound in acute dyspnea.Methods: A total of 202 patients with acute dyspnea who came to the emergency department of our hospital from January2019 to June 2020 were selected for the study.Routine medical history collection,physical examination,ecg,blood biochemistry and radiology auxiliary examination were performed on the patient first,and then the correct diagnosis result was obtained based on the patient’s final follow-up.Subsequently,two senior attending physicians of the emergency department who had received relevant emergency and critical ultrasound training used a portable ultrasound detector to quickly explore the patients and obtain the ultrasound diagnosis results by adopting the emergency bedside pulmonary ultrasound examination scheme.However,the physicians who performed the ultrasound examination were completely unaware of the previous diagnosis and relevant examination results of the patients.The results of ultrasound diagnosis were then compared with the correct diagnosis to evaluate the effectiveness of bedside ultrasound in the diagnosis of acute dyspnea.Data were analyzed using Stata 14 and Microsoft Office Excel 2013.Categorical variables were reported as frequency and percentage,and for continuous variables,as mean(standard deviation)and median(interquartile spacing)of normal and skewness distributions,respectively.The accuracy,sensitivity,specificity,positive predictive value,negative predictive value,positive likelihood ratio and negative likelihood ratio were compared with the correct diagnostic results.Results:On the whole,The bedside ultrasound diagnosis was correct in 70.3% of the patients,Sensitivity for pulmonary edema,pneumonia,and chronic obstructive pulmonary disease / asthma were 77.8%,67.1%,and 67.1%,respectively;The specificity was 84.1%,85.8% and 86.4%,respectively;The positive likelihood ratio was 4.89(95%CL: 3.30-7.23),4.73(95%CL: 2.97-7.54)and 4.92(95%CL: 3.11-7.80),respectively;The negative likelihood ratio was 0.26(95%CL: 0.15-0.46),0.38(95%CL:0.28-0.52),and 0.38(95%CL: 0.27-0.53),respectively.Conclusion: In this study,bedside ultrasound provided a diagnostic accuracy of 70.3%.Combined with its fast,safe and real-time characteristics,it has certain supplementary value in the etiological diagnosis and differential diagnosis of acute dyspnea in the emergency department,and has potential benefit for the treatment of such patients.