scholarly journals Prospective, observational study comparing automated and visual point-of-care urinalysis in general practice

BMJ Open ◽  
2016 ◽  
Vol 6 (8) ◽  
pp. e011230 ◽  
Author(s):  
Sanne van Delft ◽  
Annelijn Goedhart ◽  
Mark Spigt ◽  
Bart van Pinxteren ◽  
Niek de Wit ◽  
...  
Keyword(s):  
General Practice ◽  
Observational Study ◽  
Prospective Observational Study ◽  
Point Of Care

scholarly journals Use and impact of point-of-care ultrasonography in general practice: a prospective observational study

BMJ Open ◽  
2020 ◽  
Vol 10 (9) ◽  
pp. e037664
Author(s):  
Camilla Aakjær Andersen ◽  
John Brodersen ◽  
Annette Sofie Davidsen ◽  
Ole Graumann ◽  
Martin Bach B Jensen
Keyword(s):  
General Practice ◽  
Observational Study ◽  
Prospective Observational Study ◽  
Point Of Care ◽  
Secondary Outcome ◽  
Diagnostic Process ◽  
Median Frequency ◽  
Frequency Of Use ◽  
Point Of Care Ultrasonography ◽  
The Relationship

ObjectivesTo describe how general practitioners (GPs) use point-of-care ultrasonography (POCUS) and how it influences the diagnostic process and treatment of patients.DesignProspective observational study using an online questionnaire before and after POCUS.SettingOffice-based general practice.ParticipantsTwenty GPs consecutively recruited all patients examined with POCUS in 1 month.Primary and secondary outcome measuresWe estimated the use of POCUS through the indication for use, the frequency of use, the time consumption, the extent of modification of the examination and the findings.The influence on the diagnostic process was estimated through change in the tentative diagnoses, change in confidence, the ability to produce ultrasound images and the relationship between confidence and organs scanned or tentative diagnoses.The influence of POCUS on patient treatment was estimated through change in plan for the patient, change in patient’s treatment and the relationship between such changes and certain findings.ResultsThe GPs included 574 patients in the study. POCUS was used in patient consultations with a median frequency of 8.6% (IQR: 4.9–12.6). Many different organs were scanned covering more than 100 different tentative diagnoses. The median time taken to perform POCUS was 5 min (IQR: 3–8). Across applications and GPs, POCUS entailed a change in diagnoses in 49.4% of patients; increased confidence in a diagnosis in 89.2% of patients; a change in the management plan for 50.9% of patients including an absolute reduction in intended referrals to secondary care from 49.2% to 25.6%; and a change in treatment for 26.5% of patients.ConclusionsThe clinical utilisation of POCUS was highly variable among the GPs included in this study in terms of the indication for performing POCUS, examined scanning modalities and frequency of use. Overall, using POCUS altered the GPs’ diagnostic process and clinical decision-making in nearly three out of four consultations.Trial registration numberNCT03375333.

scholarly journals Prospective observational study of point-of-care creatinine in trauma

2016 ◽  
Vol 1 (1) ◽  
pp. e000014 ◽  
Author(s):  
Anthony J Carden ◽  
Edgardo S Salcedo ◽  
Nam K Tran ◽  
Eric Gross ◽  
Jennifer Mattice ◽  
...  
Keyword(s):  
Observational Study ◽  
Prospective Observational Study ◽  
Point Of Care

scholarly journals Can point-of-care ultrasound predict spinal hypotension during caesarean section? A prospective observational study

Anaesthesia ◽  
2017 ◽  
Vol 73 (1) ◽  
pp. 15-22 ◽  
Author(s):  
L. Zieleskiewicz ◽  
A. Noel ◽  
G. Duclos ◽  
M. Haddam ◽  
A. Delmas ◽  
...  
Keyword(s):  
Caesarean Section ◽  
Observational Study ◽  
Prospective Observational Study ◽  
Point Of Care ◽  
Point Of Care Ultrasound ◽  
Spinal Hypotension

scholarly journals Pre-hospital suPAR, lactate and CRP measurements for decision-making: a prospective, observational study of patients presenting non-specific complaints

2021 ◽  
Vol 29 (1) ◽  
Author(s):  
Milla Jousi ◽  
Marja Mäkinen ◽  
Johanna Kaartinen ◽  
Leena Meriläinen ◽  
Maaret Castrén
Keyword(s):  
Decision Making ◽  
Observational Study ◽  
Prospective Observational Study ◽  
Point Of Care ◽  
Vital Signs ◽  
Hospital Setting ◽  
Medical Systems ◽  
Urokinase Plasminogen Activator Receptor ◽  
Support Tool ◽  
Chief Complaints

Abstract Background In the pre-hospital setting, non-urgent patients with non-specific chief complaints pose assessment challenges for the emergency medical systems (EMS). Severely ill patients should be identified among these patients, and unnecessary transport to the emergency department (ED) should be avoided. Unnecessary admissions burden EDs, deplete EMS resources and can even be harmful to patients, especially elderly patients. Therefore, tools for facilitating pre-hospital decision-making are needed. They could be based on vital signs or point-of-care laboratory biomarkers. In this study, we examined whether the biomarker soluble urokinase plasminogen activator receptor (suPAR), either alone or combined with C-reactive protein (CRP) and/or lactate, could predict discharge from the ED and act as a pre-hospital support tool for non-conveyance decision-making. Methods This was a prospective, observational study of adult patients with normal or near-normal vital signs transported by an EMS to an ED with a code referring to deteriorated general condition. The levels of suPAR, CRP and lactate in the patients’ pre-hospital blood samples were analysed. The values of hospitalized patients were compared to those of discharged patients to determine whether these biomarkers could predict direct discharge from the ED. Results A total of 109 patients (median age: 81 years) were included in the study. Of those, 52% were hospitalized and 48% were discharged from the ED. No statistically significant association was found between suPAR and the ED discharge vs hospitalization outcome (OR: 1.04, 95% CI 0.97–1.13, AUROC: 0.58, 95% CI 0.47–0.69). Adding CRP (AUROC: 0.64, 95% CI 0.54–0.75) or lactate (AUROC: 0.60, 95% CI 0.49–0.71) to the regression models did not improve their diagnostic accuracy. None of the patients with a suPAR value of less than 2 ng/ml were admitted to hospital, while 64% of the patients with a suPAR value of more than 6 ng/ml were hospitalized. Conclusion Pre-hospital suPAR measurements alone or combined with CRP and/or lactate measurements could not predict the ED discharge or hospital admission of 109 non-urgent EMS patients with non-specific chief complaints and normal or near-normal vital signs.

Sepsis-Induced Myocardial Dysfunction in Pediatric Septic Shock: Prevalence, Predictors, and Outcome—A Prospective Observational Study

2021 ◽  
Author(s):  
Viresh S. Swami ◽  
Lalitha A. V. ◽  
Santu Ghosh ◽  
Mounika Reddy
Keyword(s):  
Septic Shock ◽  
Observational Study ◽  
Patient Outcomes ◽  
Prospective Observational Study ◽  
Point Of Care ◽  
Myocardial Dysfunction ◽  
Severity Of Illness ◽  
Serum Lactate ◽  
Lactate Levels ◽  
Organ Dysfunctions

AbstractThere is a paucity of literature on the prevalence, predictors, prognostic markers, and outcomes of sepsis-induced myocardial dysfunction (SMD) in pediatric septic shock. The objectives of our study were to estimate the prevalence of SMD in pediatric septic shock by point-of-care functional echocardiography (POCFE) and to study the association of SMD with severity of illness, organ dysfunctions, and outcomes. This prospective, observational study was conducted over a period of 1 year (from July 2018 to July 2019) in a 12-bed, tertiary pediatric intensive care unit (PICU) of an academic and referral hospital in South India. Children presenting with septic shock were enrolled in the study. POCFE was done within 6 hours of PICU admission and patients were categorized as having SMD based on POCFE findings. The prevalence of SMD (left ventricle ± right ventricle) was 32% (32/100). More than half of the children (54.5%) died in SMD group, whereas only 7.5% died in non-SMD group (p < 0.001). SMD was associated with higher organ dysfunctions, worse patient outcomes, and was found to be an independent predictor of mortality. The median lactate levels were higher in SMD group (3.15 [2.7, 5] vs. 2 [1.3, 2.7], p < 0.001) as compared with non-SMD group. We observed significantly lower median lactate clearance at 6 hours in SMD than non-SMD (30.0% [−14.44, 44.22] vs. 59.8% [45.83, 71.43], p < 0.001). Lactate levels at 6 hours with a threshold of 2.4 mmol/L was a good predictor of SMD with sensitivity and specificity of 73 and 80%, respectively. SMD is not an uncommon entity in children with septic shock. SMD was associated with worse patient outcomes, organ dysfunction, and mortality. Serum lactate trends may predict SMD and can be used as prognosticate markers as well.

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