Data from: Impact of point-of-care ultrasound on clinical decision-making at an urban emergency department in Tanzania

Background: Point of care ultrasound (PoCUS) is an efficient, inexpensive,
safe, and portable imaging modality that can be particularly useful in
resource-limited settings. However, its impact on clinical decision making
in such settings has not been well studied. The objective of this study is
to describe the utilization and impact of PoCUS on clinical decision
making at an urban emergency department in Dar es Salaam, Tanzania.
Methods: This was a prospective descriptive cross-sectional study of
patients receiving PoCUS at Muhimbili National Hospital's Emergency
Medical Department (MNH EMD). Data on PoCUS studies during a period of 10
months at MNH EMD was collected on consecutive patients during periods
when research assistants were available. Data collected included patient
age and gender, indications for ultrasound, findings, interpretations, and
provider-reported diagnostic impression and disposition plan before and
after PoCUS. Descriptive statistics, including medians and interquartile
ranges, and counts and percentages, are reported. Pearson chi squared
tests and p-values were applied to categorical data to evaluate for
significant differences. Results: PoCUS data was collected for 986 studies
performed on 784 patients. Median patient age was 32 years; 56% of
patients were male. Top indications for PoCUS included trauma, respiratory
presentations, and abdomino-pelvic pain. The most frequent study types
performed were eFAST, cardiac, and obstetric or gynaecologic studies.
Overall, clinicians reported that the use of PoCUS changed either
diagnostic impression or disposition plan in 29% of all cases. Rates of
change in diagnostic impression or disposition plan increased to 45% in
patients for whom more than one PoCUS study type was performed.
Conclusions: In resource-limited emergency care settings, PoCUS can be
utilized for a wide range of indications and has substantial impact on
clinical decision making, especially when more than one study type is
performed.