Diagnostic Performance of Echocardiography Performed by Emergency Physicians After a Basic Training

NCT02974790 | Terminated

• 1 other identifier: I16035 (ECHOBEDSIDE)
• Study Type: observational
• Target: 89
• Locations: 1 country
• Sites: 1

Brief Summary

After a basic training to echocardiography, emergency physicians will have to answer simple clinical questions about circulatory failure mechanisms. The objective of the study is to assess the agreement between these answers and those of the expert physician in patients admitted in the emergency department with a circulatory failure due to sepsis or not. Emergency physicians will volunteer to take part in a basic training on echocardiography. The training will include 4 hours of theory, 2 hours of interactive clinical cases and 6 hours of tutored practice at patients' bedside (10 to 15 examinations). The objective of the practice sessions will be to learn the technical grounds of transthoracic echocardiography (TTE), the different views and to identify the anatomical structures. The second part of the study will start after the training. Each eligible patient will be successively assessed by two investigators: one emergency physician recently trained and the expert physician. The echocardiography will be performed as soon as possible in the emergency department before or after the initiation of treatment without delaying it. The order of hemodynamic assessments will be random depending on the availability of the investigators; both assessments will however be performed within 30 minutes. Each investigator will independently read the echocardiography in real time at patients' bedside. They will then answer a limited list of standardized questions using two-choice answers or predefined choices. Finally investigators will choose a therapeutic proposition among a predefined list based on the answers. Only the results of the echocardiography performed by the expert physician will be used in patient management.

Conditions

Circulatory Failure; Echocardiography

Keywords

echocardiography; training; emergency department; circulatory failure

Outcome Measures

Primary Outcomes (1)

• Agreement between emergency physician and referee physician echocardiography

  Agreement between the measurements performed using two-dimensional imaging echocardiography by an emergency physician and the referring physician according to the following data : * size of the left ventricle * systolic function of the left ventricle * size of the right ventricle * dysfunction of the right ventricle * size of the inferior vena cava pericardial effusion

  Day 1

Secondary Outcomes (1)

• Agreement between emergency physicians and referring physician therapeutic propositions

  Day 1

Study Arms (1)

Circulatory failure

Patients with a circulatory failure due to a sepsis or not

Procedure: Echocardiography

Interventions

Echocardiography PROCEDURE

Two-dimensional imaging echocardiography

Circulatory failure

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Probability Sample

Study Population

Hemodynamic assessment will target patients with circulatory failure and / or sepsis in emergency unit

You may qualify if:

• patients \> 18 years old
• patients admitted in the Emergency Department of Limoges University Hospital
• patients with circulatory failure defined as 1 or more of the following criteria :
• clinical signs of tissue hypoperfusion
• mottling
• Encephalopathy
• Oliguria \< 0.5 ml/kg/h
• biological signs of hypoperfusion
• Lactate \> 2 mmol/L
• AND/OR Low blood pressure defined as a sBP \< 90 mmHg or mBP \< 65 mmHG or decrease of sBP \> 40 mmHg compared with usual blood pressure
• OR Patients with signs of sepsis recently defined as the following :
• Suspicion of clinical infection
• At least 2 of the 3 following items (i.e. SOFA \> 2 points with 1 point/item) :
• Glasgow score \< 13
• Respiratory rate \> 22 cycle/min

You may not qualify if:

• Pregnant patients
• Moribund patients or with limited care
• Patients under legal protection

Sponsors & Collaborators

• University Hospital, Limoges: lead
• University Hospital, Tours: collaborator

Study Sites (1)

Limoges University Hospital

Limoges, 87042, France

Location

MeSH Terms

Conditions

Shock; Emergencies

Condition Hierarchy (Ancestors)

Pathologic Processes; Pathological Conditions, Signs and Symptoms; Disease Attributes

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: PROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: November 23, 2016
• First Posted: November 28, 2016
• Study Start: January 2, 2017
• Primary Completion: January 2, 2018
• Study Completion: March 2, 2018
• Last Updated: March 29, 2018

Record last verified: 2018-03

Data Sharing

• IPD Sharing: Will not share

Locations

FR (1)