Durchführbarkeit präklinischer Sonographie bei Patienten mit Luftnot und Thoraxschmerz im bodengebundenen Rettungsdienst im Landkreis Marburg/Biedenkopf
Purpose: To examine the feasibility and diagnostic value of a novel preclinical chest ultrasound algorithm in dyspnoeic patients. Patients and methods: Between October 2008 and April 2009, 56 patients (29 male, 27 female, mean age 67.3 years, range 20-90) with acute dyspnoea (breathing rate > 20/min) underwent chest sonography with a portable ultrasound device (SonoSite, Micromaxx). The algorithm included 5 sectional views (4 chamber subxyphoidal view, left and right laterodorsal view of the chest wall, left and right anterior intercostal space view) screening for pleural and pericardial effusion, right heart distension, and pneumothorax. The preclinical sonographic findings were confirmed by chest x-ray, ultrasonography and clinical follow-up in the emergency room. Results: Ultrasound was performed on scene (65%) and in the ambulance car (35%). The mean time for the algorithm took 2.0 minutes (range 1-5 minutes). The most common diagnoses associated with acute dyspnoea were 1) acute coronary syndrome (ACS) (n = 12, 21%), 2) congestive heart failure (CHF) (n=11, 20%) and chronic obstructive pulmonary disease (COPD) (n = 10, 18%). Pleural effusion was detected in 100% of patients with CHF, 17% of ACS and 20% of COPD patients constituting the most helpful parameter in differential diagnosis. Ultrasonography provided a helpful tool in n = 38, 68%, and additional therapeutic consequences were drawn in n = 14, 25%. Conclusion: We present a novel preclinical chest ultrasound algorithm for the management of dyspnoeic patients, in particular for differential diagnosis of CHF, COPD and ACS.
Hoffmann, Saskia Martina Karin: Durchführbarkeit präklinischer Sonographie bei Patienten mit Luftnot und Thoraxschmerz im bodengebundenen Rettungsdienst im Landkreis Marburg/Biedenkopf. : Philipps-Universität Marburg 2016-06-30. DOI: https://doi.org/10.17192/z2016.0435.