BRIPPED Scan for Evaluation of Emergency Department (ED) Patients With Shortness of Breath (BRIPPED)

August 13, 2013 updated by: Eastern Virginia Medical School

BRIPPED Scan for Evaluation of Emergency Department Patients With Shortness of Breath

The B-RIPPED scan is a standardized ultrasound evaluation of pulmonary B-lines, Right ventricle size and strain, Inferior Vena Cava collapsibility, Pleural and Pericardial Effusion, Pneumothorax, Ejection Fraction, and lower extremity Deep Venous Thrombosis. Primary outcomes measured are the magnitude of change in differential diagnoses.

Study Overview

Status

Completed

Conditions

Detailed Description

This prospective randomized control trial will be performed on a convenience sample of 200 patients presenting with undifferentiated SOB to an academic emergency department (ED) (volume 56,000 patients/year). Subjects are excluded if they have a known history of asthma, are 20 or more weeks pregnant, or have had thoraco-abdominal trauma in the past 72 hours. The BRIPPED pilot investigation (IRB #10-02-FB-0026) enrolled 43 patients and physician subjects from 4/30/2010 to 1/20/2011. This study differs in methodology from the pilot study in the reduction of the total number of ultrasound images obtained to decrease the total time to perform the scan. Instead of a cohort study, this randomized control trial includes the addition of a control group for cost and time saved comparison. As in the pilot study, eligible patients will be evaluated by the treating ED physician who will rank potential diagnoses from most to least likely. A study investigator performs the B-RIPPED scan and provides the initial treating physician with the results. The treating physician will again be asked to complete a differential diagnosis ranking knowing the B-RIPPED results. Changes in the differential diagnosis ranking, physician orders, and interventions will be compiled. A randomized control cohort will be assigned for eligible patients. In the control group, the treating physician will complete the diagnosis rank list prior to the completion of the workup, and then once all lab values are back. Time to disposition, and comparison of labs and radiology tests ordered will be compared to the cohort receiving the BRIPPED scan. Patients will be assigned a number at time of enrollment, which randomly assigns them to the control or experimental (patients receiving the BRIPPED scan) group. Packets containing the appropriate data collection form (control or experimental) will be organized so even numbered patients will belong to one group, and odd numbered patients will be assigned to the other.

Study Type

Observational

Enrollment (Actual)

104

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

    • Virginia
      • Norfolk, Virginia, United States, 23507
        • Sentara Norfolk General Emergency Department

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

18 years to 89 years (Adult, Older Adult)

Accepts Healthy Volunteers

Yes

Genders Eligible for Study

All

Sampling Method

Non-Probability Sample

Study Population

A convenience sample of community subjects presenting to an Academic Hospital Emergency Department (volume approx 60,000 patients per year).

Description

Inclusion Criteria:

Subjects are included if they are between the ages of 18-89 and present to the Emergency Department with a chief complaint of shortness of breath or dyspnea.

Exclusion Criteria:

  • known history of asthma,
  • are 20 or more weeks pregnant, or
  • have had thoraco-abdominal trauma in the past 72 hours.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

Cohorts and Interventions

Group / Cohort
BRIPPED scan
Patients presenting with undifferentiated shortness of breath who receive the ultrasound scan in addition to standard of care
Control
Patients who only receive the standard of care for undifferentiated shortness of breath

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Time Frame
magnitude of change of differential diagnosis of the treating physician
Time Frame: duration of ED course, which is expected to be an average of 3 hours
duration of ED course, which is expected to be an average of 3 hours

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
time to complete the exam
Time Frame: 3 to 30 minutes during the ED course
3 to 30 minutes during the ED course
time to disposition in control group compared to group receiving the BRIPPED scan
Time Frame: duration of ED course, which is expected to be an average of 3 hours, with a range of 45 minutes to 6 hours
duration of ED course, which is expected to be an average of 3 hours, with a range of 45 minutes to 6 hours
labs, consults, medications and other orders added or discontinued after the treating physician is informed of the BRIPPED scan results
Time Frame: duration of the ED course, which is expected to be an average of 3 hours, with a range of 45 minutes to 6 hours
duration of the ED course, which is expected to be an average of 3 hours, with a range of 45 minutes to 6 hours
Recidivism rates among both cohorts, or evaluation of return to the ED within 30 days
Time Frame: 30 days after presentation to ED
Electronic medical record review of patients who present with shortness of breath 30 days after initial presentation, evaluation and treatment
30 days after presentation to ED

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Investigators

  • Principal Investigator: Virginia M Stewart, MD, Eastern Virginia Medical School

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start

October 1, 2011

Primary Completion (Actual)

May 1, 2012

Study Completion (Actual)

May 1, 2012

Study Registration Dates

First Submitted

February 16, 2012

First Submitted That Met QC Criteria

August 9, 2012

First Posted (Estimate)

August 10, 2012

Study Record Updates

Last Update Posted (Estimate)

August 14, 2013

Last Update Submitted That Met QC Criteria

August 13, 2013

Last Verified

August 1, 2013

More Information

Terms related to this study

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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