Purpose:
Our institution has recently implemented a point-of-care (POC) ultrasound training program, consisting of an e-learning course and systematic practical hands-on training. The aim of this prospective study was to evaluate the learning outcome of this curriculum.
Materials and Methods:
16 medical students with no previous ultrasound experience comprised the study group. The program covered a combination of 4 well-described point-of-care (POC) ultrasound protocols (focus assessed transthoracic echocardiography, focused assessment with sonography in trauma, lung ultrasound, and dynamic needle tip positioning for ultrasound-guided vascular access) and it consisted of an e-learning course followed by 4?h of practical hands-on training. Practical skills and image quality were tested 3 times during the study: at baseline, after e-learning, and after hands-on training.
Results:
Practical skills improved for all 4 protocols; after e-learning as well as after hands-on training. The number of students who were able to perform at least one interpretable image of the heart increased from 7 at baseline to 12 after e-learning, p<0.01, and to all 16 students after hands-on-training, p<0.01. The number of students able to cannulate an artificial vessel increased from 3 to 8 after e-learning and to 15 after hands-on training.
Conclusion:
Medical students with no previous ultrasound experience demonstrated a considerable improvement in practical skill after interactive e-learning and 4?h of hands-on training.
Background
The COVID‐19 pandemic demanded changes in societal behavior and health care worldwide. Previous studies have compared trauma patient admissions in COVID‐19‐related lockdowns to prior years. This study describes the COVID‐19 impact on trauma patient admissions during entire 2020 at a major trauma center in Denmark.
Methods
We retrospectively analyzed trauma patients received by a trauma team and admitted at Aarhus University Hospital in 2020 compared with 2018–2019. The incidence of injuries, mechanism of injury, 30‐day mortality, and Injury Severity Score (ISS) were investigated.
Results
The incidence of minor injuries (ISS 1–15) increased by 24% in 2020 compared with 2018–2019 (incidence rate ratio 1.24 [95% CI: 1.11–1.39]). The incidence of severe injuries (ISS >15) in 2020 did not change compared with 2018–2019 (incidence rate ratio 0.97 [95% CI: 0.80–1.17]). The 30‐day mortality was similar in 2020 compared with 2018–2019. Comparing 2020 with 2018–2019, the risk ratio of traffic injuries decreased (0.90 [95% CI: 0.82–0.99]), risk ratio for fall injuries was 1.13 (95% CI: 0.97–1.30), for violence 1.13 (95% CI: 0.51–2.50), and for self‐harm 1.94 (95% CI: 0.95–3.94). During the first lockdown of 2020, trauma team activations declined from 49.5 to 42 and the risk ratio for traffic injuries was 0.74 (95% CI: 0.50–1.10) compared with the same period in 2018–2019.
Conclusion
The incidence of minor injuries increased, but the incidence of severe injuries was similar in 2020 compared with 2018–2019. Societal restrictions might alter the mechanism of injuries. The first lockdown indicated an association with reduced traffic injuries.
The early and transient acute dilatation of the RV, coinciding with D-shaping of the LV and decrease in LV end-diastolic area seen in our study represent a combination of ultrasonographic characteristics normally attributed to pulmonary embolism. Early changes in ventricular chamber sizes and shape with septal flattening related to asphyxia can occur, but appear to be transient and disappear as circulatory collapse progresses, in an animal model. Despite this, asphyxia may represent a cause of ultrasonographic misinterpretation.
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