Featured Research

from universities, journals, and other organizations

Point-of-care ultrasound proves accurate for kids with suspected appendicitis

Date:
February 10, 2014
Source:
Mount Sinai Medical Center
Summary:
Appendicitis, the most common potential surgical problem for kids seen in the emergency department, can be visualized with a high degree of accuracy using point-of-care ultrasound. Using it as first-line imaging study of choice also reduces kids' exposure to ionizing radiation.

Using portable ultrasound as a first-line imaging study in kids with suspected appendicitis helps reduce emergency room length of stay and reduces the need for CT scans, according to a team of Mount Sinai researchers. Bedside ultrasound, often referred to as point-of-care ultrasonography, has a specificity of about 94%, meaning that it misses few cases, , the Mt. Sinai researchers add. Results from the study are published online February 10 in the peer-reviewed journal Academic Emergency Medicine.

"From an institutional perspective, this is the most common surgical problem that we encounter with children in the emergency department," said the study's senior author, James W. Tsung, MD, MPH, associate professor of emergency medicine and pediatrics at the Icahn School of Medicine at Mount Sinai. "CT scans have been the best imaging test for diagnosing appendicitis, but they expose children to radiation, which cumulatively can prove harmful, as increasing numbers of studies have shown." Several studies have reported lifetime risks of cancer from abdominal and pelvis CT in children between 1 fatal cancer cause for every 500 to 3,000 CT scans ordered, depending on age and sex. Efforts to try to reduce the 4 million radiation-emitting CT scans obtained in children every year are underway, led by front-line physicians, radiologists, and radiological professional societies. "CT scanning rate was reduced by over 35%, from a 44% CT scan rate prior to the study to a 27% rate during the study," commented Ee Tay, MD, assistant professor of emergency medicine and pediatrics, Icahn School of Medicine at Mount Sinai, and the study's second author.

In the study, investigators used a prospective observational convenience sample of 150 children seen consecutively between May 1, 2011 and October 1, 2012 in an urban pediatric emergency department. All children were under evaluation for suspected appendicitis. Outcomes were determined by surgical or pathology report in those found to have appendicitis and three weeks later in patients who were deemed not to have appendicitis. Operator accuracy reading the ultrasounds was reviewed in a blinded fashion by trained pediatric emergency medicine sonologists. The time to perform the point-of-care ultrasound and CT scan use was measured.

The study showed that emergency department length of stay declined by 2 hrs and 14 minutes (46% decrease) for those requiring radiology department ultrasound and nearly 6 hours (68% decrease) for those requiring CT scan when point-of-care ultrasound was inconclusive as a first-line imaging study. Importantly, no cases of appendicitis were missed with the point-of-care ultrasound protocol and no unnecessary surgeries were performed for a normal appendix. With focused ultrasound training, pediatric emergency clinicians were able to evaluate ultrasound exams with the similar accuracy as radiologists (about 94% accuracy).

Dr. Tsung noted: "Surgeons are becoming more comfortable using ultrasound for decision-making and that is a big change from reliance on CT scans." The Mt. Sinai Division of Emergency Ultrasound is involved with an effort to educate providers at Mount Sinai Hospital to use safer ultrasound as a faster first-line study in kids.


Story Source:

The above story is based on materials provided by Mount Sinai Medical Center. Note: Materials may be edited for content and length.


Journal Reference:

  1. Inna Elikashvili, Ee Tein Tay, James W. Tsung. The Effect of Point-of-care Ultrasonography on Emergency Department Length of Stay and Computed Tomography Utilization in Children With Suspected Appendicitis. Academic Emergency Medicine, 2014; 21 (2): 163 DOI: 10.1111/acem.12319

Cite This Page:

Mount Sinai Medical Center. "Point-of-care ultrasound proves accurate for kids with suspected appendicitis." ScienceDaily. ScienceDaily, 10 February 2014. <www.sciencedaily.com/releases/2014/02/140210184549.htm>.
Mount Sinai Medical Center. (2014, February 10). Point-of-care ultrasound proves accurate for kids with suspected appendicitis. ScienceDaily. Retrieved July 24, 2014 from www.sciencedaily.com/releases/2014/02/140210184549.htm
Mount Sinai Medical Center. "Point-of-care ultrasound proves accurate for kids with suspected appendicitis." ScienceDaily. www.sciencedaily.com/releases/2014/02/140210184549.htm (accessed July 24, 2014).

Share This




More Matter & Energy News

Thursday, July 24, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Creative Makeovers for Ugly Cellphone Towers

Creative Makeovers for Ugly Cellphone Towers

AP (July 24, 2014) Mobile phone companies and communities across the country are going to new lengths to disguise those unsightly cellphone towers. From a church bell tower to a flagpole, even a pencil, some towers are trying to make a point. (July 24) Video provided by AP
Powered by NewsLook.com
Algonquin Power Goes Activist on Its Target Gas Natural

Algonquin Power Goes Activist on Its Target Gas Natural

TheStreet (July 23, 2014) When The Deal's Amanda Levin exclusively reported that Gas Natural had been talking to potential suitors, the Ohio company responded with a flat denial, claiming its board had not talked to anyone about a possible sale. Lo and behold, Canadian utility Algonquin Power and Utilities not only had approached the company, but it did it three times. Its last offer was for $13 per share as Gas Natural's was trading at a 60-day moving average of about $12.50 per share. Now Algonquin, which has a 4.9% stake in Gas Natural, has taken its case to shareholders, calling on them to back its proposals or, possibly, a change in the target's board. Video provided by TheStreet
Powered by NewsLook.com
Robot Parking Valet Creates Stress-Free Travel

Robot Parking Valet Creates Stress-Free Travel

AP (July 23, 2014) 'Ray' the robotic parking valet at Dusseldorf Airport in Germany lets travelers to avoid the hassle of finding a parking spot before heading to the check-in desk. (July 23) Video provided by AP
Powered by NewsLook.com
Boeing Ups Outlook on 52% Profit Jump

Boeing Ups Outlook on 52% Profit Jump

Reuters - Business Video Online (July 23, 2014) Commercial aircraft deliveries rose seven percent at Boeing, prompting the aerospace company to boost full-year profit guidance- though quarterly revenues missed analyst estimates. Bobbi Rebell reports. Video provided by Reuters
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:
from the past week

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile: iPhone Android Web
Follow: Facebook Twitter Google+
Subscribe: RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins