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KMID : 1037620160030010015
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Pediatric Emergency Medicine Journal
2016 Volume.3 No. 1 p.15 ~ p.23
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Point-of-care ultrasound may reduce emergency department length of stay in children with nonspecific manifestations of intussusception
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Han Sung-Min
Kim Jung-Heon
Lee Jong-Seung
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Abstract
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Purpose: To investigate whether performance of point-of-care ultrasound (POCUS) can reduce emergency department length of stay (EDLOS) for children with nonspecific manifestations of intussusception (NMI), defined as 2 or less manifestations of the classic triad of intussusception, and/or vomiting.
Methods: We reviewed medical records of 141 consecutive children with intussusception aged 6 years or younger who visited the emergency department of Asan Medical Center in Seoul, Korea from May 2014 through April 2016 and underwent
diagnostic radiology ultrasound and pneumatic reduction. The children were grouped according to whether they underwent
POCUS or not (POCUS and no POCUS groups, respectively). POCUS was performed to children with NMI by an attending
emergency physician who had completed a POCUS training course endorsed by the Korean Society of Pediatric Emergency Medicine. We measured EDLOS, which consisted of door-to-reduction and observation times. These time intervals were compared between the 2 groups.
Results: Of 112 eligible children, 65 (58%) underwent POCUS. The median EDLOS was shorter in the POCUS group than in
the no POCUS group (566 minutes, interquartile range [IQR] 497 to 765 vs. 745 minutes, IQR 551 to 981; P = 0.003). The median door-to-reduction and observation times were also shorter in the POCUS group (105 vs. 138 minutes, P < 0.001 and 440 vs. 628 minutes, P = 0.008, respectively). These differences were possibly due to the performance of POCUS and the trend toward early discharge after pneumatic reduction. We found 1 child with false negative result on POCUS, but there may have been more.
Conclusion: Performance of POCUS may reduce EDLOS in children with NMI.
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KEYWORD
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Child, Emergency Service, Hospital, Intussusception, Length of Stay, Point-of-Care Systems, Ultrasonography
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