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Emergency Department Resource Use in Pediatric Pneumonia: Point-of-Care Lung Ultrasonography versus Chest Radiography

Maya Harel-Sterling1, Mamadou Diallo1, Sabeena Santhirakumaran1

  • 1Department of Pediatrics, Division of Emergency Medicine, Hospital for Sick Children, Toronto, Ontario, Canada.

Journal of Ultrasound in Medicine : Official Journal of the American Institute of Ultrasound in Medicine
|July 21, 2018
PubMed

Insights

Point-of-care lung ultrasonography (US) significantly reduced emergency department (ED) time and costs for diagnosing community-acquired pneumonia (CAP) in children compared to chest radiography. This imaging method offers a faster, more economical alternative for pediatric CAP diagnosis.

Area of Science:

  • Pediatric Emergency Medicine
  • Diagnostic Imaging
  • Pulmonology

Background:

  • Community-acquired pneumonia (CAP) is a common pediatric illness.
  • Chest radiography is a standard diagnostic tool for CAP.
  • Point-of-care lung ultrasonography (US) offers a portable alternative to radiography.

Purpose of the Study:

  • To compare pediatric emergency department (ED) time metrics for point-of-care lung US versus chest radiography in suspected CAP.
  • To evaluate differences in health system costs and resource utilization between the two imaging modalities.

Main Methods:

  • Retrospective matched cohort study.
  • Inclusion of children aged 0-18 years with suspected CAP.
  • Comparison of time metrics (physician assessment to discharge, overall ED length of stay) and costs between lung US and chest radiography groups.

Main Results:

  • The point-of-care lung US group had a mean reduction of 75.9 minutes from physician assessment to discharge and 60.9 minutes in overall ED length of stay.
  • Physician billings and facility fees were significantly lower in the lung US group.
  • Mean health system savings of CAN$187.1 were observed in the lung US group.

Conclusions:

  • Point-of-care lung US performed by pediatric emergency physicians is associated with decreased ED time for children with suspected CAP.
  • Lung US demonstrated significant cost savings compared to chest radiography.
  • This study supports lung US as an efficient and cost-effective imaging modality for pediatric CAP.
Abstract

Keywords:
lung ultrasonographypediatric emergencypneumoniapoint-of-care ultrasonographyresource use

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