Objectives: The objective was to assess the incidence of various technical errors committed by emergency physicians (EPs) learning to perform focused assessment with sonography in trauma (FAST).Methods: This was a retrospective review of the first 75 consecutive FAST exams for each EP from April 2000 to June 2005. Exams were assessed for noninterpretable views, misinterpretation of images, poor gain, suboptimal depth, an incomplete exam, or backward image orientation.Results: A total of 2,223 FAST exams done by 85 EPs were reviewed. Multiple noninterpretable views or misinterpreted images occurred in 24% of exams for those performing their first 10 exams, 3.6% for those performing their 41st to 50th exams, and 0% for those performing their 71st to 75th exams (CochranArmitage trend test = 10.5, p < 0.0001). A single noninterpretable view, poor gain, suboptimal depth, incomplete exam, or backward image orientation occurred in 48% of exams for those performing their first 10 exams, 17% for those performing their 41st to 50th exams, and 5% for those performing their 71st to 75th exams (Cochran-Armitage trend test = 11.6, p < 0.0001). Conclusions:The incidence of specific technical errors of EPs learning to perform FAST at our institution improved with hands-on experience. Interpretive skills improved more rapidly than image acquisition skills.

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Objective:To assess the religious spirituality of EMS personnel and their perception of the spiritual needs of ambulance patients.Methods:Emergency medical technicians (EMTs) and paramedics presenting to an urban, academic emergency department (ED) were asked to complete a three-part survey relating to demographics, personal practices, and perceived patient needs. Their responses were compared to those of ambulance patients presenting to an ED during a previous study period and administered a similar survey.Results:A total of 143 EMTs and 89 paramedics returned the surveys. There were 161 (69.4%) male and 71 (30.6%) female respondents with a median age range of 26–35 years old. Eighty-seven percent believed in God, 82% practiced prayer or meditation, 62% attended religious services occasionally, 55% belonged to a religious organization, 39% felt that their beliefs affected their job, and 18% regularly read religious material. This was similar to the characteristics of ambulance patients.However, only 43% felt that occasionally ambulance patients presented with spiritual concerns and 78% reported never or rarely discussing spiritual issues with patients. Contrastingly, &gt;40% of ambulance patients reported spiritual needs or concerns at the time of ED presentation, and &gt;50% wanted their providers to discuss their beliefs. Twenty-six percent of respondents reported praying or meditating with patients, while 50% reported praying or meditating for patients.Females were no more religious or spiritual than males, but were more likely to engage in prayer with (OR = 2.38,p= 0.0049) or for (OR = 6.45,p&lt;0.0001) patients than their male counterparts.Conclusion:EMTs and paramedics did not perceive spiritual concerns as often as reported by ambulance patients, nor did they commonly inquire about the religious/spiritual needs of patients.

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