Multicentre randomised controlled trial incorporating bedside lung ultrasound into the diagnosis of congestive cardiac failure in breathless older patients.

Improving diagnosis of cardiac failure in breathless older patients using lung ultrasound.

Grant ID: EMPJ103R19 2013

Lay Summary

Many older persons present to the Emergency Department complaining of shortness of breath (Dyspnoea). This can be an important forewarning of heart failure, but is also present in many other conditions. In most cases, several bedside tests are carried out to identify those patients with heart failure. Despite these investigations, which include blood tests, electrocardiograph and chest x-ray, heart failure is initially misdiagnosed in up to one quarter of patients in the emergency department. This project focuses on secondary prevention of the complications of the disease caused by missed diagnosis.

Some European hospitals use bedside lung ultrasound as an adjunct to the above tests, claiming it improves recognition of heart failure, and should decrease the time to appropriate treatment. The European model of ultrasound practice is significantly different from the Australian model, and there is limited evidence supporting either model provided in the literature.

This is a multi-centre study following on from a successful pilot project. A safe, simple protocol has been tested in an Australian Emergency Department, in parallel to normal diagnostic strategies. To prove the protocol actually improves patient care, it now has to be tested as part of the diagnostic workup for breathlessness compared with the conventional diagnostic procedure.

Leveraged Funds



Journal articles
- Baker K., Mitchell G., Thompson A., Stieler G., Rippey J., 'Lung ultrasound in heart failure: Lessons from re-analysis of Lung Ultrasound 2011 database', "Australia Journal of Ultrasound in Medicine", 2015 DOI: 10.1002/j.2205-0140.2015.tb00018.x

Conference Presentations/Abstracts:
-Australasian Society for Ultrasound in Medicine, Annual Scientific Meeting, Point of Care stream, Sydney, 10-11th September. Invited speaker and clinical lead (45 minute oral presentation followed by 1.5 hour practical workshop on 10th).
-Australasian College for Emergency Medicine, Annual Scientific Meeting, Brisbane 25th November, invited speaker (30 minute oral presentation)

Invited Expert:
- Invited Speaker for Emergency Medicine Ultrasound Group (Sydney) meeting on 10th September-30 minute oral presentation.
- Invited facilitator of Point of Care Workshop (Cooma, August 1st)- one day workshop for rural generalists arranged by Sue Loucks of Australasian Society for Ultrasound in Medicine.
- Invited speaker/tutor/lung expert for Ultrafest (Perth, August 17-22nd) - five day course in general point of care ultrasound, run by Drs Adrian Goudie and James Rippey.



Amount Awarded


Grant Scheme


Principal Investigator:
Dr Kylie Baker

Co Investigators:
Prof Geoffrey Mitchell
Dr Geoffrey Stieler
Dr Katherine Isoardi
Dr Ogilvie Thom

Associate Investigators:
Dr Stephen Brierley
Dr Frances Kinnear
A/Prof Kevin Chu


Collaborating Institutions


  • Queensland Times, 4 May 2017
  • Seven News story 2016
  • Sunshine Coast Daily, 4 May 2017
  • 3 May 2017
  • The Australian Doctor, 5 July 2016
  • Ipswich Times, 1 February 2014
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