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Evaluation of hand infections in the emergency department using point-of-care ultrasound

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  • 国家科技期刊平台
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  • NSTL
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Evaluation of hand infections in the emergency department using point-of-care ultrasound
BACKGROUND:We aimed to evaluate the utility of point-of-care ultrasound(POCUS)in the assessment of hand infections that present to the emergency department(ED)and its impact on medical decision making and patient management.METHODS:We conducted a retrospective review of patients who presented to two urban academic EDs with clinical presentations concerning for skin and soft tissue infections(SSTI)of the hand between December 2015 and December 2021.Two trained POCUS fellowship physicians reviewed an ED POCUS database for POCUS examinations of the hand.We then reviewed patients'electronic health records(EHR)for demographic characteristics,history,physical examination findings,ED course,additional imaging studies,consultations,impact of POCUS on patient care and final disposition.RESULTS:We included a total of 50 cases(28 male,22 female)in the final analysis.The most common presenting symptoms and exam findings were pain(100%),swelling(90%),and erythema(74%).The most common sonographic findings were edema(76%),soft tissue swelling(78%),and fluid surrounding the tendon(57%).POCUS was used in medical decision making 68%of the time(n=34),with the use of POCUS leading to changes in management 38%of the time(n=19).POCUS use led to early antibiotic use(11/19),early consultation(10/19),and led to the performance of a required procedure(8/19).The POCUS diagnosis was consistent with the discharge diagnosis of flexor tenosynovitis 8/12 times,abscess 12/16 times,and cellulitis 14/20 times.CONCLUSION:POCUS is beneficial for evaluating of hand infections that present to the ED and can be used as an important part of medical decision making to expedite patient care.

UltrasoundPoint-of-care ultrasoundCellulitisAbscessFlexor tenosynovitis

David Ahmad Haidar、David Mintz、Brandon M Wubben、Omar Rizvi、Srikar Adhikari

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Department of Emergency Medicine,Michigan Medicine,Ann Arbor 48109-1382,USA

University of Arizona College of Medicine,Tucson 85724,USA

Department of Emergency Medicine,University of Iowa,Iowa City 52242-1009,USA

Department of Surgery,University of Arizona College of Medicine,Tucson 85724,USA

Department of Emergency Medicine,University of Arizona College of Medicine,Tucson 85724,USA

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Ultrasound Point-of-care ultrasound Cellulitis Abscess Flexor tenosynovitis

2024

10.5847/wjem.j.1920-8642.2024.049

世界急诊医学杂志(英文)
浙江大学,浙江大学医学院附属第二医院

世界急诊医学杂志(英文)

ISSN：1920-8642
年,卷(期)：2024.15(4)