Results of the implementation of a doublecheck protocol with point-of-care ultrasound for acute heart failure in the emergency department
Tomás Villén1*, Yale Tung2, Rafael Llamas3, Fernando Neria1, César Carballo4, José Luis Vázquez5 and Diana Monge1
Abstract
Objective To determine the effectiveness of a double-check protocol using Point-of-Care Ultrasound in the management of patients diagnosed with Acute Heart Failure in an Emergency Department.
Method Prospective analytical cross-sectional observational study with patients diagnosed with Acute Heart Failure by the outgoing medical team, who undergo multi-organ ultrasound evaluation including cardiac, pulmonary, and inferior vena cava ultrasound.
Results 96 patients were included. An alternative diagnosis was found in 33% of them. Among the 77% where AHF diagnosis was confirmed, 73.4% had an underlying cause or condition not previously known (Left Ventricular Ejection Fraction less than 40% or moderate-severe valvulopathy). The introduction of the protocol had a clinically relevant impact on 47% of all included patients.
Conclusions The implementation of a double-check protocol using POCUS, including cardiac, pulmonary, and inferior vena cava assessment in patients diagnosed with Acute Heart Failure, demonstrates a high utility in ensuring accurate diagnosis and proper classification of these patients.
Keywords Ultrasonography, Heart failure, Diagnosis, Diagnostic errors
GKB-NON-2024-00273