Impact of bedside right upper quadrant ultrasonography on radiology imaging

Many Emergency Departments (ED) use emergency ultrasonography of the right upper quadrant (RUQ) to capture images of the gallbladder in patients with suspected gallstones. It is unclear what impact this practice has on additional imaging performed by radiology. Patients were enrolled 24 h a day by ED residents and attending physicians who have completed an educational program in limited RUQ ultrasound. All ultrasounds were videotaped and later reviewed. According to the American College of Emergency Physicians' credentialing standards, 25 ultrasounds were required before using the results clinically. A total of 352 patients were enrolled by 42 physicians over a 1-year period. Two hundred twelve (60.2%) of the ultrasounds were performed clinically, with the rest performed for teaching purposes. One hundred seventy-nine (50.9%) of the ultrasounds were performed by credentialed physicians. One hundred forty-nine (70%) clinical and 29 (20.7%) teaching ultrasounds had additional imaging. The average time to follow up imaging after discharge from the ED was 8.51 days. Most patients receiving emergency ultrasound of their RUQ had follow-up imaging by radiology.