University of Lynchburg DMSc Doctoral Project Assignment Repository

University of Lynchburg DMSc Doctoral Project Assignment Repository


Emergency Medicine


Justin C Morrison PA-C, DMSC, MPAM


Shortness of breath is one of the most common presenting symptoms in the Emergency Department setting. According to many studies, this presentation accounts for nearly 20% of ED visits1, roughly 3.4 million visits annually.2 While the etiology contains multiple differentials, there will be a chest x-ray ordered as a standard of care. Sensitivity is lower and may often result in requiring a follow up CT scan of the chest. Additionally, interventions may require reassessment via repeat imaging. This is a significant amount of radiation when considered over the lifespan of an individual. Increased in amount chest x-rays have shown increased risk of both lung and breast cancer.3 Depending upon the experience level of the provider, point of care ultrasound (POCUS) has shown improved sensitivity and specificity on identifying common pulmonary pathology such as pneumothorax, effusion, atelectasis, and pneumonia.4 The CT may be inevitable, but there is value in attempting to avoid chest x-ray to prevent unnecessary radiation.


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