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Jarman RD, Colclough A, McDermott C, Bøtker M, Knudsen L, Harris T, Albaroudi B, Albaroudi O, Haddad M, Darke R, Berry E, Breslin T, Fitzpatrick G, Flanagan L, Olusanya O, Craver D, Omar A, Simpson T, Cherian N, Dore M, Prosen G, Kay S, Villén-Villegas T, Gargani L, Carley S, Woo M, Dupriez F, Hussain A, Via G, Connolly JA, Peck M, Melniker L, Walden A, Attard Biancardi MA, Żmijewska-Kaczor O, Lalande E, Geukens P, McLaughlin R, Olszynski P, Hoffmann B, Chin E, Muhr C, Kim DJ, Mercieca A, Shukla D, Hayward S, Smith M, Gaspari R, Smallwood N, Pes P, Tavazzi G, Corradi F, Lambert M, Morris C, Trauer M, Baker K, Bystrzycki A, Goudie A, Liu R, Rudd L, Dietrich CF, Jenssen C, Sidhu PS. EFSUMB Clinical Practice Guidelines for Point-of-Care Ultrasound: Part One (Common Heart and Pulmonary Applications) SHORT VERSION. Ultraschall Med 2023; 44:36-49. [PMID: 36228630 DOI: 10.1055/a-1882-6116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
OBJECTIVE To evaluate the evidence and produce a summary and recommendations for the most common heart and lung point-of-care ultrasound (PoCUS). METHODS We reviewed 10 clinical domains/questions related to common heart and lung applications of PoCUS. Following review of the evidence, a summary and recommendations were produced, including assigning levels of evidence (LoE) and grading of recommendation, assessment, development, and evaluation (GRADE). 38 international experts, the expert review group (ERG), were invited to review the evidence presented for each question. A level of agreement of over 75 % was required to progress to the next section. The ERG then reviewed and indicated their level of agreement of the summary and recommendation for each question (using a 5-point Likert scale), which was approved in the case of a level of agreement of greater than 75 %. A level of agreement was defined as a summary of "strongly agree" and "agree" on the Likert scale responses. FINDINGS AND RECOMMENDATIONS One question achieved a strong consensus for an assigned LoE of 3 and a weak GRADE recommendation (question 1), the remaining 9 questions achieved broad agreement with an assigned LoE of 4 and a weak GRADE recommendation (question 2), three achieved an LoE of 3 with a weak GRADE recommendation (questions 3-5), three achieved an LoE of 3 with a strong GRADE recommendation (questions 6-8) and the remaining two were assigned an LoE of 2 with a strong GRADE recommendation (questions 9 and 10). CONCLUSION These consensus-derived recommendations should aid clinical practice and highlight areas of further research for PoCUS in acute settings.
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Affiliation(s)
- Robert David Jarman
- Emergency Department, Royal Victoria Infirmary, Newcastle upon Tyne, United Kingdom of Great Britain and Northern Ireland
- School of Health and Life Sciences, Teesside University, Middlesbrough, United Kingdom of Great Britain and Northern Ireland
| | - Anna Colclough
- Emergency Medicine, University Hospital Lewisham, London, United Kingdom of Great Britain and Northern Ireland
| | - Cian McDermott
- Emergency Medicine, Mater Hospital School, Dublin, Ireland
| | - Morten Bøtker
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
- Prehospital Emergency Medical Services, Central Denmark Region, Viborg, Denmark
| | - Lars Knudsen
- Department of Anaesthesia, Aarhus University Hospital, Aarhus, Denmark
| | - Tim Harris
- Emergency Medicine, Queen Mary University of London, United Kingdom of Great Britain and Northern Ireland
- Emergency Medicine, Hamad Medical Corporation, Doha, Qatar
| | | | - Omar Albaroudi
- Emergency Medicine, Hamad Medical Corporation, Doha, Qatar
| | - Mahmoud Haddad
- Emergency Medicine, Hamad Medical Corporation, Doha, Qatar
| | - Robert Darke
- Emergency Medicine and Intensive Care Medicine, Health Education England North East, Newcastle upon Tyne, United Kingdom of Great Britain and Northern Ireland
| | - Edward Berry
- Emergency Medicine, Torbay Hospital, Torquay, United Kingdom of Great Britain and Northern Ireland
| | - Tomas Breslin
- Emergency Medicine, Mater Misericordiae University Hospital, Dublin, Ireland
- School of Medicine, University College Dublin, Ireland
| | | | - Leah Flanagan
- Emergency Medicine, Mater Misericordiae University Hospital, Dublin, Ireland
| | - Olusegun Olusanya
- Intensive Care Medicine, University College Hospital, London, United Kingdom of Great Britain and Northern Ireland
| | - Dominic Craver
- Emergency Medicine, The Royal London Hospital, London, United Kingdom of Great Britain and Northern Ireland
| | - Adhnan Omar
- Respiratory Medicine, University Hospital Lewisham, London, United Kingdom of Great Britain and Northern Ireland
| | - Thomas Simpson
- Respiratory Medicine, Lewisham and Greenwich NHS Trust, London, United Kingdom of Great Britain and Northern Ireland
| | - Nishant Cherian
- Emergency Department, The Alfred Emergency & Trauma Centre, Melbourne, Australia
- School of Health and Life Sciences, Teesside University, Middlesbrough, United Kingdom of Great Britain and Northern Ireland
| | - Martin Dore
- Emergency Medicine, Royal Devon and Exeter NHS Foundation Trust, Exeter, United Kingdom of Great Britain and Northern Ireland
| | - Gregor Prosen
- Center for Emergency Medicine, University Medical Centre Maribor, Slovenia
| | - Sharon Kay
- Cardiac Physiology and Echocardiography, The University of Sydney, Australia
| | | | - Luna Gargani
- Cardiology, Institute of Clinical Physiology National Research Council, Pisa, Italy
| | - Simon Carley
- Emergency Medicine, Manchester University NHS Foundation Trust, Manchester, United Kingdom of Great Britain and Northern Ireland
- Emergency Medicine, Manchester Metropolitan University, Manchester, United Kingdom of Great Britain and Northern Ireland
| | - Michael Woo
- Emergency Medicine, University of Ottawa, Canada
- Emergency Medicine, Ottawa Hospital Research Institute, Ottawa, Canada
| | - Florence Dupriez
- Emergency Medicine, Cliniques universitaires Saint-Luc, Bruxelles, Belgium
| | - Arif Hussain
- Cardiac Critical Care, King Abdulaziz Medical City, Riyadh, Saudi Arabia
| | - Gabriele Via
- Istituto Cardio Centro, EOC, Lugano, Switzerland
| | - James Anthony Connolly
- Emergency Medicine, Royal Victoria Infirmary, Newcastle-upon-Tyne, United Kingdom of Great Britain and Northern Ireland
| | - Marcus Peck
- Anaesthesia and Intensive Care, Frimley Park Hospital NHS Trust, Frimley, United Kingdom of Great Britain and Northern Ireland
| | - Larry Melniker
- Emergency Medicine, NewYork-Presbyterian Brooklyn Methodist Hospital, Brooklyn, United States
| | - Andrew Walden
- Acute and Intensive Care Medicine, Royal Berkshire Hospital, Reading, United Kingdom of Great Britain and Northern Ireland
- Acute Medicine and Intensive Care Medicine, University of Oxford, United Kingdom of Great Britain and Northern Ireland
| | | | - Olga Żmijewska-Kaczor
- Emergency Medicine, Royal Cornwall Hospital, Truro, United Kingdom of Great Britain and Northern Ireland
| | - Elizabeth Lalande
- Emergency Medicine, Centre Hospitalier de l'Université Laval, Sainte-Foy, Canada
| | - Paul Geukens
- Intensive Care Medicine, Hopital de Jolimont, Haine-Saint-Paul, Belgium
| | - Russell McLaughlin
- Emergency Medicine, Royal Victoria Hospital, Belfast, United Kingdom of Great Britain and Northern Ireland
- Medical Director, Northern Ireland Ambulance Service, Belfast, United Kingdom of Great Britain and Northern Ireland
| | - Paul Olszynski
- Emergency Medicine, University of Saskatchewan, Saskatoon, Canada
| | - Beatrice Hoffmann
- Emergency Department, Harvard Medical School Department of Emergency Medicine Beth Israel Deaconess Medical Center, Boston, United States
| | - Eric Chin
- Emergency Medicine, Brooke Army Medical Center, Fort Sam Houston, United States
| | - Christopher Muhr
- Emergency Medicine and Internal Medicine, Capio Sankt Gorans Sjukhus, Stockholm, Sweden
| | - Daniel J Kim
- Emergency Medicine, The University of British Columbia, Vancouver, Canada
- Emergency Medicine, Vancouver General Hospital, Vancouver, Canada
| | | | | | - Simon Hayward
- Physiotherapy, Blackpool Teaching Hospitals NHS Foundation Trust, Blackpool, United Kingdom of Great Britain and Northern Ireland
| | - Michael Smith
- School of Healthcare Sciences, Cardiff University College of Biomedical and Life Sciences, Cardiff, United Kingdom of Great Britain and Northern Ireland
| | - Romolo Gaspari
- Emergency Medicine, UMass Memorial Medical Center, Worcester, United States
- Emergency Medicine, UMass Medical School, Worcester, United States
| | - Nick Smallwood
- Acute Medicine, East Surrey Hospital, Redhill, United Kingdom of Great Britain and Northern Ireland
| | - Philippe Pes
- Emergency Medicine, University Hospital Centre Nantes, France
| | - Guido Tavazzi
- Anesthesia and Intensive Care Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
- Dipartimento di Scienze Clinico-Chirurgiche, Diagnostiche e Pediatriche, Università degli Studi di Pavia Facoltà di Medicina e Chirurgia, Pavia, Italy
| | - Francesco Corradi
- Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, Italy
| | - Michael Lambert
- Emergency Medicine, Advocate Christ Medical Center, Oak Lawn, United States
| | - Craig Morris
- Intensive Care, Royal Derby Hospital, Derby, United Kingdom of Great Britain and Northern Ireland
| | - Michael Trauer
- Emergency Medicine, St Thomas' Hospital, London, United Kingdom of Great Britain and Northern Ireland
| | - Kylie Baker
- Emergency Medicine, Ipswich Hospital, Ipswich, Australia
- Faculty of Medicine, The University of Queensland, Saint Lucia, Australia
| | - Adam Bystrzycki
- Emergency Medicine, The Alfred Emergency & Trauma Centre, Melbourne, Australia
- Department of Epidemiology & Preventive Medicine, Monash University, Clayton, Australia
| | - Adrian Goudie
- Emergency Medicine, Fiona Stanley Hospital, Murdoch, Australia
| | - Rachel Liu
- Emergency Medicine, Yale School of Medicine, New Haven, United States
| | - Lynne Rudd
- General Secretary, European Federation of Societies for Ultrasound in Medicine and Biology (EFSUMB), London, United Kingdom of Great Britain and Northern Ireland
| | - Christoph F Dietrich
- Department Allgemeine Innere Medizin, Kliniken Hirslanden Beau Site, Salem und Permanence, Bern, Switzerland
| | - Christian Jenssen
- Klinik für Innere Medizin, Krankenhaus Märkisch Oderland, Strausberg/Wriezen, Germany
| | - Paul S Sidhu
- Radiology, King's College London, United Kingdom of Great Britain and Northern Ireland
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Jarman RD, McDermott C, Colclough A, Bøtker M, Knudsen L, Harris T, Albaroudi B, Albaroudi O, Haddad M, Darke R, Berry E, Breslin T, Fitzpatrick G, Flanagan L, Olusanya O, Craver D, Omar A, Simpson T, Cherian N, Dore M, Prosen G, Kay S, Villén-Villegas T, Gargani L, Carley S, Woo M, Dupriez F, Hussain A, Via G, Connolly JA, Peck M, Melniker L, Walden A, Attard Biancardi MA, Żmijewska-Kaczor O, Lalande E, Geukens P, McLaughlin R, Olszynski P, Hoffmann B, Chin E, Muhr C, Kim DJ, Mercieca A, Shukla D, Hayward S, Smith M, Gaspari R, Smallwood N, Pes P, Tavazzi G, Corradi F, Lambert M, Morris C, Trauer M, Baker K, Bystrzycki A, Goudie A, Liu R, Rudd L, Dietrich CF, Jenssen C, Sidhu PS. EFSUMB Clinical Practice Guidelines for Point-of-Care Ultrasound: Part One (Common Heart and Pulmonary Applications) LONG VERSION. Ultraschall Med 2023; 44:e1-e24. [PMID: 36228631 DOI: 10.1055/a-1882-5615] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
AIMS To evaluate the evidence and produce a summary and recommendations for the most common heart and lung applications of point-of-care ultrasound (PoCUS). METHODS We reviewed 10 clinical domains/questions related to common heart and lung applications of PoCUS. Following review of the evidence, a summary and recommendation were produced, including assignment of levels of evidence (LoE) and grading of the recommendation, assessment, development, and evaluation (GRADE). 38 international experts, the expert review group (ERG), were invited to review the evidence presented for each question. A level of agreement of over 75 % was required to progress to the next section. The ERG then reviewed and indicated their level of agreement regarding the summary and recommendation for each question (using a 5-point Likert scale), which was approved if a level of agreement of greater than 75 % was reached. A level of agreement was defined as a summary of "strongly agree" and "agree" on the Likert scale responses. FINDINGS AND RECOMMENDATIONS One question achieved a strong consensus for an assigned LoE of 3 and a weak GRADE recommendation (question 1). The remaining 9 questions achieved broad agreement with one assigned an LoE of 4 and weak GRADE recommendation (question 2), three achieving an LoE of 3 with a weak GRADE recommendation (questions 3-5), three achieved an LoE of 3 with a strong GRADE recommendation (questions 6-8), and the remaining two were assigned an LoE of 2 with a strong GRADE recommendation (questions 9 and 10). CONCLUSION These consensus-derived recommendations should aid clinical practice and highlight areas of further research for PoCUS in acute settings.
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Affiliation(s)
- Robert David Jarman
- Emergency Department, Royal Victoria Infirmary, Newcastle upon Tyne, United Kingdom of Great Britain and Northern Ireland
- School of Health and Life Sciences, Teesside University, Middlesbrough, United Kingdom of Great Britain and Northern Ireland
| | - Cian McDermott
- Emergency Medicine, Mater Misericordiae University Hospital, Dublin, Ireland
| | - Anna Colclough
- Emergency Medicine, University Hospital Lewisham, London, United Kingdom of Great Britain and Northern Ireland
| | - Morten Bøtker
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
- Prehospital Emergency Medical Services, Central Denmark Region, Viborg, Denmark
| | - Lars Knudsen
- Department of Anaesthesia, Aarhus University Hospital, Aarhus, Denmark
| | - Tim Harris
- Emergency Medicine, Queen Mary University of London, United Kingdom of Great Britain and Northern Ireland
- Emergency Medicine, Hamad Medical Corporation, Doha, Qatar
| | | | - Omar Albaroudi
- Emergency Medicine, Hamad Medical Corporation, Doha, Qatar
| | - Mahmoud Haddad
- Emergency Medicine, Hamad Medical Corporation, Doha, Qatar
| | - Robert Darke
- Emergency Medicine and Intensive Care Medicine, Health Education England North East, Newcastle upon Tyne, United Kingdom of Great Britain and Northern Ireland
| | - Edward Berry
- Emergency Medicine, Torbay Hospital, Torquay, United Kingdom of Great Britain and Northern Ireland
| | - Tomas Breslin
- Emergency Medicine, Mater Misericordiae University Hospital, Dublin, Ireland
- School of Medicine, University College Dublin, Ireland
| | | | - Leah Flanagan
- Emergency Medicine, Mater Misericordiae University Hospital, Dublin, Ireland
| | - Olusegun Olusanya
- Intensive Care Medicine, University College Hospital, London, United Kingdom of Great Britain and Northern Ireland
| | - Dominic Craver
- Emergency Medicine, The Royal London Hospital, London, United Kingdom of Great Britain and Northern Ireland
| | - Adhnan Omar
- Respiratory Medicine, University Hospital Lewisham, London, United Kingdom of Great Britain and Northern Ireland
| | - Thomas Simpson
- Respiratory Medicine, Lewisham and Greenwich NHS Trust, London, United Kingdom of Great Britain and Northern Ireland
| | - Nishant Cherian
- Emergency Medicine, The Alfred Emergency & Trauma Centre, Melbourne, Australia
- School of Health and Life Sciences, Teesside University, Middlesbrough, United Kingdom of Great Britain and Northern Ireland
| | - Martin Dore
- Emergency Medicine, Royal Devon and Exeter NHS Foundation Trust, Exeter, United Kingdom of Great Britain and Northern Ireland
| | - Gregor Prosen
- Center for Emergency Medicine, University Medical Centre Maribor, Slovenia
| | - Sharon Kay
- Cardiac Physiology and Echocardiography, The University of Sydney, Australia
| | | | - Luna Gargani
- Cardiology, Institute of Clinical Physiology National Research Council, Pisa, Italy
| | - Simon Carley
- Emergency Medicine, Manchester University NHS Foundation Trust, Manchester, United Kingdom of Great Britain and Northern Ireland
- Emergency Medicine, Manchester Metropolitan University, Manchester, United Kingdom of Great Britain and Northern Ireland
| | - Michael Woo
- Emergency Medicine, University of Ottawa, Canada
- Emergency Medicine, Ottawa Hospital Research Institute, Ottawa, Canada
| | - Florence Dupriez
- Emergency Medicine, Cliniques universitaires Saint-Luc, Bruxelles, Belgium
| | - Arif Hussain
- Cardiac Critical Care, King Abdulaziz Medical City, Riyadh, Saudi Arabia
| | - Gabriele Via
- Anesthesiology, Intensive Care and Pain Medicine, Istituto Cardiocentro Ticino Ente Ospedaliero Cantonale, Lugano, Switzerland, Pavia, Italy
| | - James Anthony Connolly
- Emergency Medicine, Royal Victoria Infirmary, Newcastle-upon-Tyne, United Kingdom of Great Britain and Northern Ireland
| | - Marcus Peck
- Anaesthesia and Intensive Care, Frimley Park Hospital NHS Trust, Frimley, United Kingdom of Great Britain and Northern Ireland
| | - Larry Melniker
- Emergency Medicine, New York-Presbyterian Brooklyn Methodist Hospital, Brooklyn, United States
| | - Andrew Walden
- Acute and Intensive Care Medicine, Royal Berkshire Hospital, Reading, United Kingdom of Great Britain and Northern Ireland
- Acute Medicine and Intensive Care Medicine, University of Oxford, United Kingdom of Great Britain and Northern Ireland
| | | | - Olga Żmijewska-Kaczor
- Emergency Medicine, Royal Cornwall Hospital, Truro, United Kingdom of Great Britain and Northern Ireland
| | - Elizabeth Lalande
- Emergency Medicine, Centre Hospitalier de l'Université Laval, Sainte-Foy, Canada
| | - Paul Geukens
- Intensive Care Medicine, Hopital de Jolimont, Haine-Saint-Paul, Belgium
| | - Russell McLaughlin
- Emergency Medicine, Royal Victoria Hospital, Belfast, United Kingdom of Great Britain and Northern Ireland
- Medical Director, Northern Ireland Ambulance Service, Belfast, United Kingdom of Great Britain and Northern Ireland
| | - Paul Olszynski
- Emergency Medicine, University of Saskatchewan, Saskatoon, Canada
| | - Beatrice Hoffmann
- Emergency Department, Harvard Medical School Department of Emergency Medicine Beth Israel Deaconess Medical Center, Boston, United States
| | - Eric Chin
- Emergency Medicine, Brooke Army Medical Center, Fort Sam Houston, United States
| | - Christopher Muhr
- Emergency Medicine and Internal Medicine, Capio Sankt Gorans Sjukhus, Stockholm, Sweden
| | - Daniel J Kim
- Emergency Medicine, The University of British Columbia, Vancouver, Canada
- Emergency Medicine, Vancouver General Hospital, Vancouver, Canada
| | | | | | - Simon Hayward
- Physiotherapy, Blackpool Teaching Hospitals NHS Foundation Trust, Blackpool, United Kingdom of Great Britain and Northern Ireland
| | - Michael Smith
- School of Healthcare Sciences, Cardiff University College of Biomedical and Life Sciences, Cardiff, United Kingdom of Great Britain and Northern Ireland
| | - Romolo Gaspari
- Emergency Medicine, UMass Memorial Medical Center, Worcester, United States
- Emergency Medicine, UMass Medical School, Worcester, United States
| | - Nick Smallwood
- Acute Medicine, East Surrey Hospital, Redhill, United Kingdom of Great Britain and Northern Ireland
| | - Philippe Pes
- Emergency Medicine, University Hospital Centre Nantes, France
| | - Guido Tavazzi
- Anesthesia and Intensive Care Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
- Dipartimento di Scienze Clinico-Chirurgiche, Diagnostiche e Pediatriche, Università degli Studi di Pavia Facoltà di Medicina e Chirurgia, Pavia, Italy
| | - Francesco Corradi
- Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, Italy
| | - Michael Lambert
- Emergency Medicine, Advocate Christ Medical Center, Oak Lawn, United States
| | - Craig Morris
- Intensive Care, Royal Derby Hospital, Derby, United Kingdom of Great Britain and Northern Ireland
| | - Michael Trauer
- Emergency Medicine, St Thomas' Hospital, London, United Kingdom of Great Britain and Northern Ireland
| | - Kylie Baker
- Emergency Medicine, Ipswich Hospital, Ipswich, Australia
- Faculty of Medicine, The University of Queensland, Saint Lucia, Australia
| | - Adam Bystrzycki
- Emergency Medicine, The Alfred Emergency & Trauma Centre, Melbourne, Australia
- Department of Epidemiology & Preventive Medicine, Monash University, Clayton, Australia
| | - Adrian Goudie
- Emergency Medicine, Fiona Stanley Hospital, Murdoch, Australia
| | - Rachel Liu
- Emergency Medicine, Yale School of Medicine, New Haven, United States
| | - Lynne Rudd
- General Secretary, European Federation of Societies for Ultrasound in Medicine and Biology (EFSUMB), London, United Kingdom of Great Britain and Northern Ireland
| | - Christoph F Dietrich
- Department Allgemeine Innere Medizin, Kliniken Hirslanden Beau Site, Salem und Permanence, Bern, Switzerland
| | - Christian Jenssen
- Klinik für Innere Medizin, Krankenhaus Märkisch Oderland Strausberg/ Wriezen, Germany
| | - Paul S Sidhu
- Radiology, King's College London, United Kingdom of Great Britain and Northern Ireland
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