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Author Spotlight: Workflow for Integrating POCUS Data into EHR for Managing Heart Failure Patients
Published on: July 12, 2024
Diagnosing Acute Heart Failure in the Pediatric Emergency Department Using Point-of-Care Ultrasound
Alia Hamad1, Carrie Ng1, Kiyetta Alade1
1Department of Pediatrics, Section of Emergency Medicine, Texas Children's Hospital, Baylor College of Medicine, Houston, Texas.
Insights
Pediatric emergency physicians can use cardiac point-of-care ultrasound (POCUS) to quickly diagnose acute heart failure (AHF) in children. This tool aids in early recognition, improving patient outcomes and reducing mortality.
Area of Science:
- Pediatric Emergency Medicine
- Cardiology
- Medical Ultrasound
Background:
- Acute heart failure (AHF) in children presents a significant burden, often mimicking common childhood illnesses.
- High rates of morbidity, mortality, and resource utilization are associated with pediatric AHF.
- Rapid identification of abnormal cardiac function is crucial for timely intervention.
Purpose of the Study:
- To demonstrate the utility of cardiac point-of-care ultrasound (POCUS) in diagnosing AHF in pediatric emergency settings.
- To highlight how POCUS can expedite diagnosis, management, and disposition of children with AHF.
- To emphasize the importance of POCUS as an adjunct tool for emergency physicians.
Main Methods:
- A case series of 10 children diagnosed with AHF between 2016 and 2019.
- Cardiac POCUS performed by pediatric emergency physicians prior to comprehensive echocardiograms.
- Detailed description of one case, with summaries of the other nine.
Main Results:
- Cardiac POCUS effectively assisted pediatric emergency physicians in the rapid diagnosis of AHF.
- The use of POCUS facilitated expedited management and disposition decisions.
- The findings support POCUS as a valuable tool in the emergency department for AHF.
Conclusions:
- Early recognition of AHF in children is critical for reducing morbidity and mortality.
- Cardiac POCUS, with appropriate training, is an effective adjunct for the early diagnosis and treatment of pediatric AHF.
- Emergency physicians should consider incorporating cardiac POCUS into their diagnostic armamentarium for suspected AHF.
Background:
Acute heart failure (AHF) in children is associated with significant disease burden with high rates of morbidity, mortality, and resource utilization. These children often present to the emergency department with clinical features that mimic common childhood illnesses. Cardiac point-of-care ultrasound (POCUS) can be an effective tool for rapidly identifying abnormal cardiac function.
Case Reports:
This case series documents 10 children presenting with AHF between 2016 and 2019 and demonstrates how pediatric emergency physicians used cardiac POCUS to expedite their diagnosis, management, and disposition. All cardiac POCUS was performed before comprehensive echocardiograms were completed. One case is described in detail; the other cases are summarized in a Table. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Early recognition of AHF is critical to reduce pediatric morbidity and mortality. With proper training, cardiac POCUS can be an effective adjunct and should be considered for the early diagnosis and treatment of infants and children with AHF.
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