Emergency Department Resource Use in Pediatric Pneumonia: Point-of-Care Lung Ultrasonography versus Chest Radiography

J Ultrasound Med. 2019 Feb;38(2):407-414. doi: 10.1002/jum.14703. Epub 2018 Jul 19.

Abstract

Objectives: Point-of-care lung ultrasonography (US) is an alternative to chest radiography for imaging of suspected community-acquired pneumonia (CAP) in children. We compared pediatric emergency department (ED) time metrics between children who received point-of-care lung US versus chest radiography. Secondary objectives were comparisons of health system costs and other resources in these imaging groups.

Methods: This work was a retrospective matched cohort study of children aged 0 to 18 years in an academic urban pediatric ED who were imaged for suspected CAP with either point-of-care lung US or chest radiography.

Results: A total of 202 patients (101 in each group) were included in the study. The point-of-care lung US group spent a mean of 75.9 (SE, 14.3) minutes less from physician assessment to discharge (P < .0001) and 60.9 (SE, 18.1) minutes less in the overall ED length of stay (P = .0008). Physician billings and facility fees were both significantly lower (P < .0001) in the point-of-care lung US group, for a mean health systems savings of CAN$187.1 (SE, CAN$21.9).

Conclusions: In children undergoing imaging for suspected CAP in our pediatric ED, point-of-care lung US by pediatric emergency medicine physicians was associated with decreased time and cost compared with chest radiography.

Keywords: lung ultrasonography; pediatric emergency; pneumonia; point-of-care ultrasonography; resource use.

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • Child
  • Child, Preschool
  • Cohort Studies
  • Community-Acquired Infections / diagnostic imaging
  • Emergency Service, Hospital*
  • Female
  • Health Resources / statistics & numerical data
  • Humans
  • Infant
  • Lung / diagnostic imaging
  • Male
  • Pneumonia / diagnostic imaging*
  • Point-of-Care Systems / economics
  • Point-of-Care Systems / statistics & numerical data*
  • Radiography, Thoracic / economics
  • Radiography, Thoracic / statistics & numerical data*
  • Retrospective Studies
  • Ultrasonography / economics
  • Ultrasonography / statistics & numerical data*