Use of Ultrasound in the Initial Management of Patients in Shock in the Nancy Emergency Department

Central Hospital, Nancy, France200 enrolled

Overview

Context: shock is a serious pathology where diagnostic and therapeutic speed determines the prognosis, ultrasound can be a valuable aid for the emergency physician to differentiate the different types of shock and allow appropriate treatment. Hypothesis: what are the uses of ultrasound in the initial diagnostic and therapeutic management of patients in shock at the Emergency Department of Nancy? Main outcome: Describe the use of ultrasound in the initial diagnostic and therapeutic management of patients in shock at the Nancy Emergency Department Secondary outcome: Study the contribution of the use of different ultrasound techniques in the initial diagnostic and therapeutic management of patients depending on the type of shock state

Study Type

OBSERVATIONAL

Enrollment

200

Conditions

Shock

Interventions

Use of ultrasoundDEVICE

Use of ultrasound in the initial management of patients in shock

Eligibility

Medical Language ↔ Plain English

Inclusion Criteria: * Age ≥ 18 years old * Shock (MAP \< 65 mmHg + lactate ≥ 2 mmol/l) * Admission to the Nancy ED between 01/01/2023 and 12/31/2023 * ICD-10 output coding: R57: shock, not elsewhere classified; R570: cardiogenic shock; R571: hypovolemic shock; R572: septic shock; R578: other shocks; R579: shock, unspecified; T794: traumatic shock; T782: anaphylactic shock, unspecified; or diagnosis of entry into intensive care including the word "shock" Exclusion Criteria: * Age \< 18 years old * Absence of shock * No passage through the Nancy ED * Patient whose initial treatment was carried out in another emergency department * State of shock occurring after going to the emergency department

Outcomes

Primary Outcomes

rate of ultrasound use

use of different types of ultrasound or not for diagnostic and therapeutic purposes depending on the type of shock state

Time frame: Day 0

Secondary Outcomes

rate of patients with care changes

changes in initial diagnostic and therapeutic management when an ultrasound technique is used compared to patients who did not benefit from it (duration of passage to ED and treatment, time until diagnosis, vascular filling rate, catecholamine utilization rate)