Use of Bedside Ultrasound in Emergency Department Patients With Concern for Pulmonary Embolism to Reduce CT Imaging
Status unconfirmed · Not applicable
Conditions studied: Pulmonary Embolism, Deep Vein Thrombosis Leg, Ultrasound Imaging
In brief
At most institutions, the average patient with clinical concern for PE(pulmonary embolism) will have a CT angiogram(CTA) with contrast of the lungs performed to evaluate for a clot. However, CTA has risks including contrast- induced allergic reactions and nephropathy, as well as radiation which has been linked to development of cancer later in life. There is literature that has looked at using lower extremity doppler ultrasound first to evaluate for a DVT (deep venous thrombosis) in patients where there is concern for a PE. There is also literature showing that emergency medicine physicians can perform adequate lower extremity compression ultrasounds (LCUS), at the bedside with results similar to that of the ultrasound tech. The goal of this project is to fuse both principles by having emergency medicine physicians perform LCUS at the bedside, to help reduce CTA utilization in the evaluation of PE.
Key facts
- Study ID
- NCT03532165
- Run by
- Albany Medical College
- People needed
- 300
- Starts
- 2018-04-02
- Expected to finish
- 2019-02-28
- Last updated by the study team
- 2018-05-22
Who can join
Age: 18 and older. Sex: any. Healthy volunteers: accepted.
You may qualify if…
- Clinical Concern for PE (moderate to high risk) that warrants imaging of the chest
You may not qualify if…
- Age less than 18
- nidus for DVT in upper extremity (eg. PICC (peripherally inserted central Cather) line, etc)
- already anti-coagulated at presentation
- above the knee- leg cast
- prisoners
- DVT ultrasound or CTA prior to presentation
- Hemodynamically unstable:
- SBP (systolic blood pressure) <90 for >15min
- Drop of SBP by at least 40mmHG for >15mins
- Organ hypoperfusion (eg cold extremities, mental confusion, low urine outpt <30cc/hr, etc
- need for pressors
- Other concerns in thorax necessitating inevitable CT chest imaging.
Where it is running
- Albany Medical Center Department of Emergency Medicine — Albany, New York, United States (enrolling)
Full record on ClinicalTrials.gov
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