6/29/23, 11:42 PM SHoC-ED Pathway Feedback Search Clinical Topics Home Studies SHoC ED SHoC ED Trial question What is the role of point-of-care ultrasonography protocol in emergency department patients with undifferentiated hypotension? Study design Multi-center Open label RCT Population Characteristics of study participants 49.0% female N = 273 51.0% male 273 patients (135 female, 138 male) Inclusion criteria: patients who presented to the emergency department with undifferentiated nontraumatic hypotension or shock Key exclusion criteria: pregnancy, necessity of CPR or other advanced cardiac life support interventions before enrollment, history of significant trauma in the past 24 hours, clear mechanism of shock Interventions N=138 point-of-care ultrasonography (early point-of-care ultrasonography scans plus standard care) N=135 control (usual care without any point-of-care ultrasonography) Primary outcome Rate of survival to 30 days or hospital discharge 76.5 % 76.5 76.1 57.4 % 38.3 % https://web.pathway.md/studies/reclj1361vpWshrAn 1/2 6/29/23, 11:42 PM 38 3 % SHoC-ED Pathway 19.1 % No significant difference 0.0 % Point-of-care ultrasonography Control No significant difference in the rate of survival to 30 days or hospital discharge (76.5% vs. 76.1%; AD 0.35%, 95% CI -10.2 to 11) Secondary outcomes No significant difference in intravenous fluid administration (1609 mL vs. 1683 mL; AD 74 mL, 95% CI -50.8 to 196.2) No significant difference in hospital length of stay (9.59 days vs. 9.71 days; AD 0.12 days, 95% CI -1.74 to 2.36) No significant difference in ICU length of stay (7.16 days vs. 5.14 days; AD 2.018 days, 95% CI -0.85 to 4.63) Safety outcomes No significant difference in rates of CT scanning and rates of inotrope administration. Conclusion In patients who presented to the emergency department with undifferentiated nontraumatic hypotension or shock, point-of-care ultrasonography was not superior to control with respect to the rate of survival to 30 days or hospital discharge. Reference Paul R Atkinson, James Milne, Laura Diegelmann et al. Does Point-of-Care Ultrasonography Improve Clinical Outcomes in Emergency Department Patients With Undifferentiated Hypotension? An International Randomized Controlled Trial From the SHoC-ED Investigators. Ann Emerg Med. 2018 Oct;72(4):478-489. Open reference URL https://web.pathway.md/studies/reclj1361vpWshrAn 2/2