{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"institution":[{"name":"medRxiv"}],"indexed":{"date-parts":[[2026,1,16]],"date-time":"2026-01-16T08:04:06Z","timestamp":1768550646109,"version":"3.49.0"},"posted":{"date-parts":[[2020,6,12]]},"group-title":"Emergency Medicine","reference-count":36,"publisher":"openRxiv","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"accepted":{"date-parts":[[2020,6,12]]},"abstract":"<jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>CoVid-19 can be a life-threatening lung disease or a trivial upper respiratory infection depending on whether the alveoli are involved. Emergency department (ED) screening in symptomatic patients with normal vital signs is frequently limited to oro-nasopharyngeal swabs. We tested the null hypothesis that patients being screened for CoVid-19 in the ED with normal vital signs and without hypoxia would have a point-of-care lung ultrasound (LUS) consistent with CoVid-19 less than 2% of the time.<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Subjects<\/jats:title>\n                    <jats:p>Subjects were identified from ED ultrasound logs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Inclusion criteria<\/jats:title>\n                    <jats:p>Age 14 years or older with symptoms prompting ED screening for CoVid-19.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Exclusion criteria<\/jats:title>\n                    <jats:p>Known congestive heart failure or other chronic lung condition likely to cause excessive B lines on LUS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Intervention<\/jats:title>\n                    <jats:p>Structured blinded ultrasound review and chart review<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Analysis<\/jats:title>\n                    <jats:p>We used a two-sided exact hypothesis test for binomial random variables. We also measured LUS diagnostic performance using computed tomography as the gold standard.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>We reviewed 77 charts; 49 met inclusion criteria. Vital signs were normal in 30\/49 patients; 10 (33%) of these patients had LUS consistent with CoVid-19. We rejected the null hypothesis (p-value &lt; 0.001). The treating physicians\u2019 interpretation of their own point of care lung ultrasounds had a sensitivity of 100% (95% CI 75%, 100%) and specificity of 80% (95% CI 68%, 89%).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>LUS has a meaningful detection rate for CoVid-19 in symptomatic ED patients with normal vital signs. We recommend at least LUS be used in addition to PCR testing when screening symptomatic ED patients for CoVid-19.<\/jats:p>\n                  <\/jats:sec>\n                <\/jats:sec>\n                <jats:sec id=\"s9\">\n                  <jats:title>Capsule<\/jats:title>\n                  <jats:sec id=\"s9a\">\n                    <jats:title>What is known<\/jats:title>\n                    <jats:p>Auscultation and chest x-ray are insufficient to screen for lung involvement when SARS-CoV-2 infection is suspected. Point of care lung ultrasound is widely available, safer, and less resource intensive than CT imaging.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"s9b\">\n                    <jats:title>What we found<\/jats:title>\n                    <jats:p>In symptomatic patients presenting to the ED even those with normal vital signs had point of care lung ultrasound evidence of alveolar level involvement 33%of patients. Point of care lung ultrasound was 100% sensitive and 80% specific compared to CT (reference standard) when evaluating patients for Covid-19.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"s9c\">\n                    <jats:title>What this adds<\/jats:title>\n                    <jats:p>Point of care lung ultrasound or similar imaging should performed when screening symptomatic patients in whom SARS-CoV-2 infection is suspected.<\/jats:p>\n                  <\/jats:sec>\n                <\/jats:sec>","DOI":"10.1101\/2020.06.09.20123836","type":"posted-content","created":{"date-parts":[[2020,6,12]],"date-time":"2020-06-12T11:05:12Z","timestamp":1591959912000},"source":"Crossref","is-referenced-by-count":6,"title":["Point of care lung ultrasound is useful when screening for CoVid-19 in Emergency Department patients"],"prefix":"10.64898","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4059-7115","authenticated-orcid":false,"given":"Paul","family":"Walsh","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrea","family":"Hankins","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Heejung","family":"Bang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"54368","reference":[{"key":"2021010310101209000_2020.06.09.20123836v1.1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(20)30154-9"},{"key":"2021010310101209000_2020.06.09.20123836v1.2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(20)30183-5"},{"key":"2021010310101209000_2020.06.09.20123836v1.3","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciaa272"},{"key":"2021010310101209000_2020.06.09.20123836v1.4","doi-asserted-by":"publisher","DOI":"10.3348\/kjr.2020.0132"},{"key":"2021010310101209000_2020.06.09.20123836v1.5","doi-asserted-by":"publisher","DOI":"10.1086\/429634"},{"key":"2021010310101209000_2020.06.09.20123836v1.6","doi-asserted-by":"publisher","DOI":"10.1186\/s12879-019-3707-y"},{"key":"2021010310101209000_2020.06.09.20123836v1.7","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa032867"},{"key":"2021010310101209000_2020.06.09.20123836v1.8","unstructured":"Institute of Medicine United States. 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