Ultrasound-based diagnosis by the physician of emergency department: simulation modeling and practical implementation

Abstract


Aim. Assessment of the impact of independent ultrasound screening by the emergency physician on the daily activities of the emergency department.

Methods. The effectiveness of the use of ultrasound screening by the emergency physician was assessed using computer-based simulation modeling and the subsequent implementation of the data obtained into the practical work of the emergency department. The results were analyzed using descriptive statistical methods.

Results. In the course of the study, a simulated model of emergency department was built, similar to the actually functioning department in the Pavlov First St. Petersburg State Medical University. The new professional emergency physician’s standard, requiring knowing the basics of ultrasound-based diagnosis, were implemented first in the model and then in everyday practice. Independent ultrasound screening by the emergency physician allows reducing the length of stay of patients in the emergency department and the workload on medical personnel at the same time increasing the capacity of the department which is confirmed both by computer simulation and by actual implementation in the daily activities of the department.

Conclusion. The data received are indicative of a positive impact of independent ultrasound screening on the hospital stay of patients in the department and workload on the medical staff; emergency residency program should be complemented by teaching the basics of ultrasound diagnosis.


V M Teplov

Pavlov First St. Petersburg State Medical University

Author for correspondence.
Email: vadteplov@mail.ru
Saint-Petersburg, Russia

E A Tsebrovskaya

Pavlov First St. Petersburg State Medical University

Email: vadteplov@mail.ru
Saint-Petersburg, Russia

V V Kolomoytsev

Pavlov First St. Petersburg State Medical University

Email: vadteplov@mail.ru
Saint-Petersburg, Russia

E A Karpova

Pavlov First St. Petersburg State Medical University

Email: vadteplov@mail.ru
Saint-Petersburg, Russia

I P Minnulin

Pavlov First St. Petersburg State Medical University

Email: vadteplov@mail.ru
Saint-Petersburg, Russia

S F Bagnenko

Pavlov First St. Petersburg State Medical University

Email: vadteplov@mail.ru
Saint-Petersburg, Russia

  1. Bagnenko S.F., Miroshnichenko A.G., Polushin Yu.S. et al. Organizatsiya raboty statsionarnogo otdeleniya skoroy meditsinskoy pomoshchi. (Organization of the in-patient emergency department service.) Moscow: GEOTAR-Media, 2015; 80 р. (In Russ.)
  2. Prefessional standard for the ambulance doctor adopted by the Ministry of Labour and Social Protection of the Russian Federation on 14th of March, 2018 №133n. (In Russ.)
  3. Hansen W., Mitchell C.E., Bhattarai B. et al. Perception of point-of-care ultrasound performed by emergency medicine physicians. J. Clin. Ultrasound. 2017; 45 (7): 408–415. doi: 10.1002/jcu.22443.
  4. Wilson S.P., Connolly K., Lahham S. et al. Point-of-care ultrasound versus radiology department pelvic ultrasound on emergency department length of stay. World J. Emerg. Med. 2016; 7 (3): 178–182. doi: 10.5847/wjem.j.1920-8642.2016.03.003.
  5. Kulikova O.M., Ovsyannikov N.V., Lyapin V.A. Simulation of the performance of medical institutions in the example of Omsk. Nauka o cheloveke: gumanitarnyye issledovaniya. 2014; (4): 219–225. (In Russ.)
  6. Yakimov I.M., Kirpichnikov A.P. Simulation of probability objects in FlexSim system. Vestnik tekhnologicheskogo universiteta. 2016; 19 (21): 170–173. (In Russ.)
  7. Pal'mov S.V., Zhuykova A.A Review of possibilities of flexsim imitation modeling system in healthcare. Mezhdunarodnyy nauchno-issledovatel'skiy zhurnal. 2018; (1): ­124–127. (In Russ.)
  8. https://healthcare.flexsim.com/whats-new-flexsim-hc/ (access date: 01.02.2019).
  9. Whitson M.R., Mayo P.H. Ultrasonography in the emergency department. Crit. Care. 2016; 20 (1): 227. doi: 10.1186/s13054-016-1399-x.
  10. Nicola R., Dogra V. Ultrasound: the triage tool in the emergency department: using ultrasound first. Br. J. Radiol. 2016; 89 (1061): 20150790. doi: 10.1259/bjr.20150790.
  11. Zhang S., Zhu D., Wan Z. et al. Utility of point-of-care ultrasound in acute management triage of earthquake injury. Am. J. Emerg. Med. 2014; 32: 92–95. doi: 10.1016/j.ajem.2013.10.009.
  12. Bagnenko S.F., Teplov V.M., Miroshnichenko A.G. et al. Experience of using of pocket-sized visualization tool in emergency department. Skoraya meditsinskaya pomoshch'. 2017; (2): ­69–72. (In Russ.)

Views

Abstract - 25

PDF (Russian) - 34

PlumX


© 2019 Teplov V.M., Tsebrovskaya E.A., Kolomoytsev V.V., Karpova E.A., Minnulin I.P., Bagnenko S.F.

Creative Commons License

This work is licensed
under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.


Свидетельство о регистрации СМИ ЭЛ № ФС 77-75008 от 1 февраля 2019 года выдано Федеральной службой по надзору в сфере связи, информационных технологий и массовых коммуникаций (Роскомнадзор)