Can emergency physicians perform extended compression ultrasound for the diagnosis of lower extremity deep vein thrombosis?

Situ-LaCasse, Elaine; Guirguis, Helpees; Friedman, Lucas; Patanwala, Asad E.; Cohen, Seth; Adhikari, Srikar

doi:10.5847/wjem.j.1920-8642.2019.04.002

Cited by 5 publications

(2 citation statements)

References 7 publications

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“…However, we think that the difference between diagnostic performance and statistical results is the result of practitioners in the other study not having previously received POCUS training. In previously reported studies, a focused education allows for POCUS to be used as an accurate and rapid imaging test, even in patients with difficult anatomical structures 13 …”

Section: Discussionmentioning

confidence: 99%

Diagnostic value of point‐of‐care ultrasound in deep vein thrombosis in the emergency department

Çanakçı

Acar

Bilgin

et al. 2020

J of Clinical Ultrasound

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Point-of-care ultrasound (POCUS) has been demonstrated as one of the primary diagnostic tools for deep vein thrombosis (DVT) screening in the emergency department, but there are quite different results in the literature regarding its diagnostic value. The aim of this study is to assess the diagnostic value of POCUS in DVT diagnosis. Methods: Patients with a clinical suspicion of DVT who underwent POCUS and were monitored by the radiology department via ultrasonography (US) or venography for DVT were retrospectively examined. POCUS examination for DVT was performed in the femoral and popliteal regions by a two-point compression technique. The inclusion criteria were age >18 years and patients with both a POCUS report and venography or US examinations performed by the radiology department (RUS) and reported by the radiology clinic. RUS and venography were considered as the gold standards. Results: The study included 266 patients. POCUS had a sensitivity of 93% (95% CI: 84-98) and specificity of 93% (95% CI: 89-96). Its positive likelihood ratio (LR +) was 14 (95% CI: 8-24), and its negative likelihood ratio (LR −) was 0.08 (95% CI: 0.03-0.19). POCUS also had a positive predictive value (PPV) of 83% (95% CI: 74-89) and a negative predictive value (NPV) of 97% (95% CI: 94-99). Conclusions: Our study verifies that POCUS has high specificity and sensitivity for the examination of the popliteal and femoral veins by an emergency physician to evaluate patients with a preliminary diagnosis of DVT.

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Section: Discussionmentioning

confidence: 99%

Diagnostic value of point‐of‐care ultrasound in deep vein thrombosis in the emergency department

Çanakçı

Acar

Bilgin

et al. 2020

J of Clinical Ultrasound

View full text Add to dashboard Cite

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“…On the other hand, when POCUS is not available, patients may require hospitalization and/or empiric anticoagulation, until DVT is definitively diagnosed or excluded. Vascular lab-or radiology-performed DVT studies are not universally available at all healthcare settings and technologists may only be available during weekday daytime hours, which delays diagnosis [39,40]. Another important point is that POCUS could be very useful in the emergent setting when resources like CTPA are available but contraindicated (pregnancy, severe renal failure and allergy to contrast) as described by Squizzato et al [41]…”

Section: Time and Resourcesmentioning

confidence: 99%

The Use of Point-of-Care Ultrasound (POCUS) in the Diagnosis of Deep Vein Thrombosis

Varrias

Palaiodimos

Balasubramanian

et al. 2021

JCM

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Acute lower extremity proximal deep venous thrombosis (DVT) requires accurate diagnosis and treatment in order to prevent embolization and other complications. Point-of-care ultrasound (POCUS), a clinician performed, and clinician interpreted bedside ultrasound examination has been increasingly used for DVT evaluation mainly in the urgent and critical care setting, but also in the ambulatory clinics and the medical wards. Studies have demonstrated that POCUS has excellent diagnostic accuracy for acute proximal DVT when performed by well-trained users. However, there is significant heterogeneity among studies on the necessary extent of training and universally acceptable standardized education protocols are needed. In this review, we summarize the evidence that supports the use of POCUS to diagnose acute proximal DVT and focus on methodology and current technology, sensitivity and specificity, pre-test probability and the role of D-dimer, time and resources, education, limitations, and future directions.

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Imaging Modalities in Venous-Thromboembolism: Ultrasound for Lower Extremity Deep Venous Thrombosis

Ben-Arie

Appelbaum

2021

Pulmonary Embolism

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Can emergency physicians perform extended compression ultrasound for the diagnosis of lower extremity deep vein thrombosis?

Abstract: Situ-LaCasse, Elaine. (2019). Can emergency physicians perform extended compression ultrasound for the diagnosis of lower extremity deep vein thrombosis?. World Journal of Emergency Medicine.

Cited by 5 publications

References 7 publications

Diagnostic value of point‐of‐care ultrasound in deep vein thrombosis in the emergency department

Diagnostic value of point‐of‐care ultrasound in deep vein thrombosis in the emergency department

The Use of Point-of-Care Ultrasound (POCUS) in the Diagnosis of Deep Vein Thrombosis

Imaging Modalities in Venous-Thromboembolism: Ultrasound for Lower Extremity Deep Venous Thrombosis

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