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JC: POCUS Effects on Length of Stay + Complex Hand Infections

This weeks readings:

Marvel BA, Budhram GR. Bedside Ultrasound in the Diagnosis of Complex Hand Infections: A Case Series. Journal of Emergency Medicine 2015;48(1):63–8.

Questions to Consider:

  • What is the current method of differentiating between different hand infections (cellulitis vs tenosynotvitis, vs joint infection etc. )
  • Should we be required to US all potential hand infections that present to the ED. (red, swollen, painful)?
  • Should cats be eliminated? 

Elikashvili I, Tay ET, Tsung JW. The Effect of Point-of-care Ultrasonography on Emergency Department Length of Stay and Computed Tomography Utilization in Children With Suspected Appendicitis. Acad Emerg Med 2014;21(2):163–70.

Questions to Consider:

  • The enrolling physician determined whether or not and what type of radiology imaging was done after performing the POCUS. How does this affect the results(Internak validity)? What about external validity?
  • This study examined the effect of POCUS on the  ED LOS of patients. How do you think POCUS affected the time efficiency of the ED physician? How might this be studied?
  • Do you think they make a strong argument with regards to radiation exposure reduction?
  • Were they able to support their argument with the results in their study?
  • If we are to rely more on US, is test performance of Ultrasound adequate?
  • How do you think the “Experienced” group affects the results?