Whitney Phillips1, Elisa Sarmiento2, Frances Russell2, Benjamin K Nti3. 1. Department of Pediatrics Riley, Hospital for Children at Indiana University Health, Indiana University School of Medicine, 705 Riley Hospital Drive, Indianapolis, IN 46202, US. 2. Division of Pediatric Emergency Medicine Division of Clinical Ultrasound Department of Emergency Medicine, Indiana University School of Medicine, 720 Eskenazi Avenue, FT 3, Indianapolis, IN 46202, US. 3. Division of Pediatric Emergency Medicine Division of Clinical Ultrasound Department of Emergency Medicine, Indiana University School of Medicine, 720 Eskenazi Avenue, FT 3, Indianapolis, IN 46202, US. bnti@iu.edu.
Abstract
BACKGROUND: Pediatric emergency department (ED) visits for superficial skin and soft tissue infections (SSTI) have steadily been increasing and point-of-care ultrasound (POCUS) continues to be an effective modality to improve management and shorter ED length of stays (LOS). OBJECTIVE: We sought to determine the impact of a soft tissue POCUS curriculum on POCUS utilization, ED LOS, and cost-effectiveness. METHODS: This was a retrospective pre- and post-interventional study of pediatric patients aged 0 to 17 years. Patients presenting to ED with international classification of disease 9 or 10 code for abscess or cellulitis were included. Data were collected a year before and after curriculum implementation with a 1-year washout training period. Training included continuing medical education, greater than 25 quality assured examinations, and a post-test. We compared diagnostic imaging type, ED LOS, and mean charges in patients with SSTI. RESULTS: We analyzed data on 119 total patients, 38 pre- and 81 post-intervention. We found a significant increase in the total number of POCUS examinations performed pre- to post-curriculum intervention, 26 vs. 59 (p = 0.0017). Mean total charges were significantly decreased from $3,762 (± 270) to $2,622 (± 158; p = 0.0009). There was a significant trend towards a decrease in average ED LOS 282 (standard error of mean [SEM] ± 19) vs 185 (± 13) minutes (p = 0.0001). CONCLUSIONS: Implementation of a soft tissue POCUS curriculum in a pediatric ED was associated with increased POCUS use, decreased LOS, and lower cost. These findings highlight the importance of POCUS education and implementation in the management of pediatric SSTI.
BACKGROUND: Pediatric emergency department (ED) visits for superficial skin and soft tissue infections (SSTI) have steadily been increasing and point-of-care ultrasound (POCUS) continues to be an effective modality to improve management and shorter ED length of stays (LOS). OBJECTIVE: We sought to determine the impact of a soft tissue POCUS curriculum on POCUS utilization, ED LOS, and cost-effectiveness. METHODS: This was a retrospective pre- and post-interventional study of pediatric patients aged 0 to 17 years. Patients presenting to ED with international classification of disease 9 or 10 code for abscess or cellulitis were included. Data were collected a year before and after curriculum implementation with a 1-year washout training period. Training included continuing medical education, greater than 25 quality assured examinations, and a post-test. We compared diagnostic imaging type, ED LOS, and mean charges in patients with SSTI. RESULTS: We analyzed data on 119 total patients, 38 pre- and 81 post-intervention. We found a significant increase in the total number of POCUS examinations performed pre- to post-curriculum intervention, 26 vs. 59 (p = 0.0017). Mean total charges were significantly decreased from $3,762 (± 270) to $2,622 (± 158; p = 0.0009). There was a significant trend towards a decrease in average ED LOS 282 (standard error of mean [SEM] ± 19) vs 185 (± 13) minutes (p = 0.0001). CONCLUSIONS: Implementation of a soft tissue POCUS curriculum in a pediatric ED was associated with increased POCUS use, decreased LOS, and lower cost. These findings highlight the importance of POCUS education and implementation in the management of pediatric SSTI.
Authors: R S Hockberger; L S Binder; M A Graber; G L Hoffman; D G Perina; S M Schneider; D P Sklar; R W Strauss; D R Viravec; W J Koenig; J J Augustine; W P Burdick; W V Henderson; L L Lawrence; D B Levy; J McCall; M A Parnell; K T Shoji Journal: Ann Emerg Med Date: 2001-06 Impact factor: 5.721
Authors: Benjamin K Nti; Sarah Kennedy; Elisa Sarmiento; Elizabeth Weinstein; Frances Russell Journal: Pediatr Emerg Care Date: 2022-02-01 Impact factor: 1.454