425 - Comparative Effectiveness of Point-of-Care Ultrasound (POCUS) versus Radiology Ultrasound in the Management of Pediatric Skin and Soft Tissue Infections in the Emergency Department

Publication Number: 425.4088

Benjamin Nti, Indiana University School of Medicine, Carmel, IN, United States; Madison Kolanowski, Indiana University School of Medicine, Carmel, IN, United States

Background: Superficial Skin and Soft Tissue Infections (SSTIs), including abscesses and cellulitis, are common in the pediatric population and have led to a gradual increase in emergency department (ED) visits. Physicians often rely on radiology ultrasound imaging to assess abscesses.

Objective: This study compared the management of pediatric abscesses between radiology ultrasound and point-of-care ultrasound (POCUS).

Design/Methods: A retrospective chart review was conducted on pediatric patients ( < 18 years old) who presented to the ED with an abscess from 2019-2023. Patients with chronic SSTI, those presenting from outside hospitals with prior imaging for SSTI, and those with complicated infections such as necrotizing fasciitis were excluded.

Results: Three hundred twenty-three patients met the inclusion criteria. Of these, 241 (74.6%) underwent radiology ultrasound, 81 (25.0%) had POCUS only, and 37 (11.4%) had both radiology and POCUS. The majority of the patient population was white (Caucasian) males, with an average age of 12 years. The average duration of POCUS exams was significantly shorter than radiology exams (5:31 minutes vs. 11:02 minutes, p < 0.0001). There was no significant difference in the rates of incision and drainage between the groups (41.6% radiology vs. 41.7% POCUS), and no complications were observed in either group. Six patients (5.8%) in the POCUS group returned to the ED within seven days of discharge, compared to three patients (2.1%) in the radiology group.

Conclusion(s): The data suggest no significant difference in outcomes between POCUS and radiology-initiated evaluation of pediatric SSTI. This implies that POCUS is not inferior to radiology ultrasound in the management of pediatric SSTI, supporting increased POCUS utilization in this context.