DGAI-zertifizierte Seminarreihe Anästhesie Fokussierte Sonografie – Modul 4: Kardiosonografie

Tonner, Peter H.; Bein, Berthold; Breitkreutz, Raoul; Broscheit, Jens; Erb, Joachim M.; Dütschke, Peter; Greim, Clemens‐Alexander; Hansen, Matthias; Kefalianakis, Fotios; Loick, H. M.; Schmidt, Christoph; Timpe, Annemarie; Wagner, Gerhard

doi:10.1055/s-0031-1297186

Cited by 7 publications

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“…After in-depth training (e.g. based on Anaesthesia-Focussed Sonography (AFS) modules, Focused Abdominal Sonography for Trauma/Focused Echocardiography in Emergency Life Support (FAST/FEEL) courses) [ 7 , 12 , 13 ], maintaining and adding to these skills requires regular training sessions for all emergency physicians (at our emergency physician base at least 30 min per week).…”

Section: Discussionmentioning

confidence: 99%

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Prehospital point-of-care emergency ultrasound: a cohort study

Scharonow

Weilbach

2018

Scand J Trauma Resusc Emerg Med

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BackgroundIn the prehospital situation, the diagnostic armamentarium available to the rescue physician is limited. Emergency ultrasound has proven to be a useful diagnostic tool, providing crucial information for the management of critically ill and injured patients. The proportion of performed ultrasound scans in all patients attended to by the rescue service team, the quality of the findings and the ultrasound-related changes in management approach and patient transport were evaluated.MethodsIn this prospective 18-month observational study, we documented all missions performed by rescue physicians with special training in emergency ultrasound (expert standard). These data were than analysed with regard to the ultrasound examinations. The ultrasound protocols used comprised Focussed Assessment with Sonography for Trauma (FAST), Prehospital Lung Ultrasound (PLUS) and Focused Echocardiography in Emergency Life support (FEEL). The quality of prehospital examinations was assessed by comparing the findings and diagnoses at the emergency site with those established in hospital. The changes in patient management and transport were documented using a standardized protocol.ResultsA total of 99 (18.1%) emergency ultrasound examinations were performed during 546 callouts. The most common indications for prehospital emergency ultrasound were dyspnoea (n = 38; 38.4%), during cardiac arrest (n = 17/17.2%), fall (n = 12/12.1%) and high-speed trauma (n = 11/11.1%). The combinations of ultrasound examination protocols in the trauma group (n = 31; 31.3%) were: 1. FAST+FEEL+PLUS (n = 17; 54.8%). 2. FAST+PLUS (n = 11; 35.5%) 3. FAST alone (n = 3; 9.7%). In the non-trauma group (n = 68; 68.7%), the following combinations were used: 1. FEEL+PLUS (n = 36; 52.9%), 2. FEEL alone (n = 21/30.9%). 3. PLUS alone (n = 6/8.8%) 4. FAST alone (n = 2; 2.9%) 5. FAST+FEEL+PLUS (n = 2; 2.9%). 6. FAST+FEEL (n = 1/1.5%). The emergency ultrasound findings impaired left ventricular contractile function (sensitivity 89.4%), right ventricular stress (85.7%), lung interstitial syndrome (100%), ruling out pneumothorax (specificity 100%), ruling out intraabdominal fluid (97,1%) were verified at the receiving hospital using ultrasonography, CT scan or x-rays; the prehospital diagnosis was confirmed in 90.8% of cases, the difference between the prehospital and in-hospital findings were not significant(p-values from p = 0.688 to p = 0,99). Ultrasound-related changes in patient management occurred in 49.5% of patients; in 33.3%, these were transported-related.ConclusionsEmergency ultrasound was as often used in the prehospital situation as it is in hospital. The ultrasound findings correlated well with in-hospital diagnostic results. Significant pathology changed patient-management, without prolonging the mission time.

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Section: Discussionmentioning

confidence: 99%

“…In an emergency situation, ultrasonography can provide guiding insights into a patient’s condition or injury pattern [ 1 , 3 – 7 ] and is considered to be a highest-priority technological tool that deserves evaluation [ 8 ].…”

Section: Introductionmentioning

confidence: 99%

Prehospital point-of-care emergency ultrasound: a cohort study

Scharonow

Weilbach

2018

Scand J Trauma Resusc Emerg Med

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“…In Germany this increased use has led to the introduction of an US curriculum in teaching programs. In 2011, the German Society of Anaesthesiology and Intensive Care Medicine (DGAI) established a modular curriculum called anesthesia-focused sonography (AFS) [4,14,25,28,29]. The first module covers basic aspects of the physical principles behind US, system and transducer technology as well as principles ofdopplersonography [4].…”

Section: Introductionmentioning

confidence: 99%

“…The second module deals with vascular sonographic techniques and options for further use [29] and the third module with US for regional anesthesia [14]. Module 4 focuses on transthoracic echocardiography (TTE) [28] and module 5 on the sonography of the thorax and abdomen [25]. Module 4 was revised after conducting this study in 2017 and is now integrated into a new training concept called "Perioperative fokussierte Echokardiographie in der Anästhesiologie und Intensivmedizin (PFE, perioperative focused echocardiography in anesthesiology and intensive care)".…”

Section: Introductionmentioning

confidence: 99%

Efficacy of a certified modular ultrasound curriculum

2020

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Background In recent years, ultrasound (US) has become more incorporated into anesthesia and intensive care medicine. The German Anesthesia Society established a modular curriculum to teach US skills. Until now, the efficacy of this modular curriculum has not been validated. Objective The main objective of this study was to determine whether there is an increase of knowledge and of psychomotor skills for the trainees in this curriculum. Material and methods After ethical committee approval, 41 anesthesia physicians were enrolled. To determine the increase of knowledge and of practical skills theoretical and practical tests performed were evaluated before and after two different US courses. Results Comparing before and after course tests, the participants showed significant improvement in theoretical multiple choice tests (p = 0.008). Regarding psychomotor skills following course 1, the trainees improved significantly in the time needed to perform the two practical tests (p = 0.03), but not in the performance of the test. Better needle visualization during simulated US-guided vessel puncture (p = 0.52) and better identification of the anatomical structures in the axillary region (p = 0.56) could not be achieved. Conclusion This study shows that although this US course curriculum has positively enhanced the trainees’ theoretical knowledge of US practice, it does not enhance the practical application of that theoretical knowledge. To improve this curriculum, a supervised clinically practical training should follow the course.

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“…Im Verlauf sollten alle zur Verfügung stehenden Diagnosemittel zusammen betrachtet und ggf. regel-mäßig wiederholt werden, um schnellstmöglich zu einem Ergebnis für eine adäquate Therapieführung zu kommen.Eine fokussierte Echokardiographie kann durch die zielgerichtete Durchführung denUntersuchungsgang auf 2-5 Minuten verkürzen und ist so in der Lage innerhalb kürzester Zeit wertvolle Erkenntnisse zu liefern(Tonner et al 2011). Geschulte Notärzte, ohne kardiologische Ausbildung, können eine korrekte Patientenzuweisung durch eine 5-minütige fokussierte Herz-Ultraschall-Untersuchung durchführen(Sobczyk et al 2015).…”

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Fokussierte transthorakale Echokardiographie bei Patienten mit akutem Koronarsyndrom (ACS) in der präklinischen Notfallmedizin

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DGAI-zertifizierte Seminarreihe Anästhesie Fokussierte Sonografie – Modul 4: Kardiosonografie

Cited by 7 publications

References 0 publications

Prehospital point-of-care emergency ultrasound: a cohort study

Prehospital point-of-care emergency ultrasound: a cohort study

Efficacy of a certified modular ultrasound curriculum

Fokussierte transthorakale Echokardiographie bei Patienten mit akutem Koronarsyndrom (ACS) in der präklinischen Notfallmedizin

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