National Journal of Emergency Medicine SEMI

Register      Login

SEARCH WITHIN CONTENT

FIND ARTICLE

Volume / Issue

Online First

Related articles

VOLUME 1 , ISSUE 3 ( September-December, 2023 ) > List of Articles

Original Article

Lung Ultrasound Using KH Screening Tool in Undifferentiated Shock Patients Arriving to ER

Esther J Monica, Meenakshisundaram Rajadurai, Salman Saeed, Prabakaran Perumal, Anand Raj, Athivaram Chaitanya Reddy, Hari Baskar, Nihas Babu, Ashwin Deepak

Keywords : Bedside lung ultrasound in emergency protocol, Emergency department, Extended focused abdominal sonogram for trauma, Fluid administration limited by lung sonography protocol, KH screening tool, Rapid ultrasound in shock protocol, Undifferentiated shock

Citation Information : Monica EJ, Rajadurai M, Saeed S, Perumal P, Raj A, Reddy AC, Baskar H, Babu N, Deepak A. Lung Ultrasound Using KH Screening Tool in Undifferentiated Shock Patients Arriving to ER. 2023; 1 (3):63-66.

DOI: 10.5005/njem-11015-0025

License: CC BY-NC 4.0

Published Online: 25-01-2024

Copyright Statement:  Copyright © 2023; The Author(s).


Abstract

Background: Detection of various types of shock in patients presented to the emergency department for early resuscitation and management with the use of lung ultrasound at the patient's bedside. Aim: The study aimed to evaluate the undifferentiated shock patients presented to the emergency department by using the KH screening tool in our hospital. Materials and methodology: All patients who presented to the emergency room (ER) with undifferentiated shock were included in this study. The KH screening tool was performed on the patient by the emergency physician taking of the patient. This study was single-centre prospective diagnostic study conducted in our hospital using the KH screening tool. Results: This study included 159 patients who presented to our emergency department. The KH screening was found to be >90% accurate in identifying patients with undifferentiated shock. In our study, of the cases, 41% fall into the 61–70 age group, 27% fall into the 51–60 age group, 13% fall into the more than 70 age group, 12% fall into the 41–50 age group, and only 8% fall into less than 40 age group, 73% of the patients were males and 27% were females and 71% of the patients in whom the KH screening tool was performed has been discharged after appropriate treatment. Conclusion: The use of the KH screening tool was successful in the majority of the patients for it was performed. The KH screening tool was easy, quick and done at the patient bedside in identifying the undifferentiated shock patients who presented to our emergency department.


HTML PDF Share
  1. Lichtenstein D. The BLUE-protocol, venous part: Deep venous thrombosis in the critically ill. Technique, results for the diagnosis of acute pulmonary embolism. In: Lichtenstein D, ed. Lung Ultrasound in the Critically Ill. Berlin, Germany: Springer-Verlag; 2015. pp. 116–140.
  2. Lichtenstein DA, Karakitsos D. Integrating lung ultrasound in the hemodynamic evaluation of acute circulatory failure (the fluid administration limited by lung sonography protocol). J Crit Care 2012;27(5):533.e11–533.e19. DOI: 10.1016/j.jcrc.2012.03.004.
  3. Lichtenstein DA, Mezière GA. Relevance of lung ultrasound in the diagnosis of acute respiratory failure. The BLUE protocol. Chest 2008;134(1):117–125. DOI: 10.1378/chest.07-2800.
  4. Ghane MR, Gharib MH, Ebrahimi A, et al. Accuracy of rapid ultrasound in shock (RUSH) exam for diagnosis of shock in critically Ill patients. Trauma Mon 2015;20(1):e20095. DOI: 10.5812/traumamon.20095.
  5. Dorothy Habrat. How to do E-FAST examination. MSD manual. 2021.
  6. Xirouchaki N, Kondili E, Prinianakis G, et al. Impact of lung ultrasound on clinical decision making in critically ill patients. Intensive Care Med 2014;40(1):57–65. DOI: 10.1007/s00134-013-3133-3.
  7. Shah VP, Tunik MG, Tsung JW. Prospective evaluation of point-of-care ultrasonography for the diagnosis of pneumonia in children and young adults. JAMA Pediatr 2013;167(2):119–125. DOI: 10.1001/2013.jamapediatrics.107.
  8. Oveland NP, Lossius HM, Wemmelund K, et al. Using thoracic ultrasonography to accurately assess pneumothorax progression during positive pressure ventilation: A comparison with CT scanning. Chest 2013;143(2):415–422. DOI: 10.1378/chest.12-1445.
  9. Caiulo VA, Gargani L, Caiulo S, et al. Lung ultrasound characteristics of community-acquired pneumonia in hospitalized children. Pediatr Pulmonol 2013;48(3):280–287. DOI: 10.1002/ppul.22585.
  10. Matamis D, Soilemezi E, Tsagourias M, et al. Sonographic evaluation of the diaphragm in critically ill patients. Technique and clinical applications. Intensive Care Med 2013;39(5):801–810. DOI: 10.1007/s00134-013-2823-1.
  11. Lichtenstein D. The SESAME-protocol. In: Lichtenstein D (ed). Lung Ultrasound in the Critically Ill. Berlin, Germany: Springer-Verlag; 2015. pp. 240–251.
  12. Vaidya T, D'costa P, Pande S. Role of Ultrasound in Evaluation of Undifferentiated shock in ICU setting. J Assoc Physicians India 2018;66(8):13–17. PMID: 31324077.
  13. Ghane MR, Gharib M, Ebrahimi A, et al. Accuracy of early rapid ultrasound in shock (RUSH) examination performed by emergency physician for diagnosis of shock etiology in critically ill patients. J Emerg Trauma Shock 2015;8(1):5–10. DOI: 10.4103/0974-2700.145406.
  14. Sasmaz MI, Gungor F, Guven R, et al. Effect of focused bedside ultrasonography in hypotensive patients on the clinical decision of emergency physicians. Emerg Med Int 2017;2017:6248687. DOI: 10.1155/2017/6248687.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.