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Establishment of ultrasound as a diagnostic aid in the referral of patients with abdominal pain in an emergency department – a pilot study

Authors Poulsen LLC, Bækgaard ES, Istre PG, Schmidt TA, Larsen T

Received 15 December 2014

Accepted for publication 31 January 2015

Published 25 March 2015 Volume 2015:7 Pages 11—15


Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 2

Editor who approved publication: Dr Hans-Christoph Pape

Liv la Cour Poulsen,1 Emilie Stokholm Bækgaard,1 Per Grosen Istre,1 Thomas Andersen Schmidt,1 Torben Larsen2

1Emergency Department, Copenhagen University Hospital, Holbaek, Denmark; 2Department of Obstetrics and Gynecology, Copenhagen University Hospital, Holbaek, Denmark

Purpose: Ultrasonography is a noninvasive, cheap, and fast way of assessing abdominal pain in an emergency department. Many physicians working in emergency departments do not have pre-existing ultrasound experience. The purpose of this study was to investigate the ability of first-year internship doctors to perform a reliable ultrasound examination on patients with abdominal pain in an emergency setting.
Materials and methods: This study took place in an emergency department in Denmark. Following a 1-day ultrasound introduction course, three doctors without prior ultrasound experience scanned 45 patients during a 2-month period. The applicability of the examinations was evaluated by subsequent control examination: computed tomography, operation, or ultrasound by a trained radiologist or gynecologist or, in cases where the patient was immediately discharged, by ultrasound image evaluation.
Results: In 14 out of 21 patients with a control examination, there was diagnostic agreement between the project ultrasound examination and the control. Image evaluation of all patients showed useful images of the gallbladder, kidneys, liver, abdominal aorta, and urinary bladder, but no useful images for either the pancreas or colon.
Conclusion: With only little formal training, it is possible for first-year internship doctors to correctly visualize some abdominal organs with ultrasonography. However, a longer study time frame, including more patients, and an ultrasound course specifically designed for the purpose of use in an emergency department, is needed to enhance the results.

Keywords: ultrasound training, emergency medicine, diagnostic imaging, acute abdomen

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