We report a new prediction model to assess gastric fluid volume using standard 2-dimentional bedside ultrasound that has several advantages over previously reported models.
Purpose Focused assessment of the gastric antrum by ultrasound is a feasible tool to evaluate the quality of the stomach content. We aimed to determine the amount of training an anesthesiologist would need to achieve competence in the bedside ultrasound technique for qualitative assessment of gastric content. Methods Six anesthesiologists underwent a teaching intervention followed by a formative assessment; then learning curves were constructed. Participants received didactic teaching (reading material, picture library, and lecture) and an interactive hands-on workshop on live models directed by an expert sonographer. The participants were instructed on how to perform a systematic qualitative assessment to diagnose one of three distinct categories of gastric content (empty, clear fluid, solid) in healthy volunteers. Individual learning curves were constructed using the cumulative sum method, and competence was defined as a 90% success rate in a series of ultrasound examinations. A predictive model was further developed based on the entire cohort performance to determine the number of cases required to achieve a 95% success rate. Results Each anesthesiologist performed 30 ultrasound examinations (a total of 180 assessments), and three of the six participants achieved competence. The average number of cases required to achieve 90% and 95% success rates was estimated to be 24 and 33, respectively. Conclusion With appropriate training and supervision, it is estimated that anesthesiologists will achieve a 95% success rate in bedside qualitative ultrasound assessment after performing approximately 33 examinations.
RésuméObjectif L'évaluation ciblée de l'antre pylorique par échographie est un outil utile pour estimer la qualité du contenu de l'estomac. Notre objectif était de déterminer la quantité de formation nécessaire à un anesthésiologiste afin d'acquérir des compétences en échographie au chevet pour l'évaluation qualitative du contenu gastrique. Méthode Six anesthésiologistes ont suivi une formation, puis une évaluation formative; des courbes d'apprentissage ont ensuite été élaborées. Les participants ont reçu un enseignement didactique (matériel de lecture, bibliothèque d'images, et cours) et suivi un atelier pratique interactif sur
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