Point of use ultrasound by general surgeons: Review of the literature and suggestions for future practice

Beggs, Andrew D; Thomas, P.

doi:10.1016/j.ijsu.2012.11.014

Cited by 33 publications

(28 citation statements)

References 36 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Over the last decades, the role of ultrasound has been integrated into different surgical clinical settings. Ultrasound is a vital diagnostic and interventional modality in trauma, surgical oncology, critical care, breast, pediatrics, endocrine, and vascular surgery [3,9,13–15,19–21]. More recently it has also been incorporated into minimally invasive surgery and in endoscopic exams [22,23].…”

Section: Discussionmentioning

confidence: 99%

The surgeon-performed ultrasound: a curriculum to improve residents’ basic ultrasound knowledge

Nassour

Spalding

Hynan

et al. 2017

Journal of Surgical Research

View full text Add to dashboard Cite

Background Despite the development of ultrasound courses by the American College of Surgeons two decades ago, many residencies lack formal ultrasound training. The aim of this study was to assess the previous ultrasound experience of residents and the efficacy of a new ultrasound curriculum by comparing pre- and post-course tests. Methods A pre-course survey and test were sent to all residents at the University of Texas Southwestern Medical Center. Pre-interns and junior residents received a didactic lecture on ultrasound basics and the extended focused assessment with sonography for trauma (EFAST) and were given hands-on practice. Finally, a post-course test and survey were sent to the pre-interns and junior residents. Results Only 11.3% of the residents reported having previous exposure to a formal ultrasound curriculum, and only 12.7% were taught by faculty. On the pre-course test, there was no difference in performance among senior residents, junior residents and pre-interns (p = 0.114). After taking the course, the pre-interns improved their performance and their average increased from 44.3% (SD = 12.4%) to 66.1% (SD = 12.2%; p < 0.001). The junior residents also had an improvement in their performance on the test after the course (p < 0.001). Junior residents performed better than pre-interns on the post-course test (p = 0.001). Conclusion The knowledge of surgical residents in ultrasound basics and EFAST can be improved with the establishment of an ultrasound curriculum. We believe that such an educational endeavor should be encouraged by all surgical residencies.

show abstract

Section: Discussionmentioning

confidence: 99%

The surgeon-performed ultrasound: a curriculum to improve residents’ basic ultrasound knowledge

Nassour

Spalding

Hynan

et al. 2017

Journal of Surgical Research

View full text Add to dashboard Cite

show abstract

“…As such, more and more physicians are looking to make the performance and interpretation of US diagnostics and US‐guided procedures an integral component of their clinical practice. It has been demonstrated that surgeons, surgical residents, and fellows use US effectively . Recognizing the potential applications of point‐of‐care US for general surgeons, the American College of Surgeons introduced a formal US course in 1996 …”

Section: The Current State Of Us Education In General Surgery Graduatmentioning

confidence: 99%

Point‐of‐Care Ultrasound in General Surgery Residency Training: A Proposal for Milestones in Graduate Medical Education Ultrasound

Beal

Sigmond

Sage-Silski

et al. 2017

J of Ultrasound Medicine

View full text Add to dashboard Cite

The use of point-of-care ultrasound (US) in the clinical setting has undergone massive growth, although its incorporation into training and practice is variable. Surgeons are interested in using point-of-care US and can incorporate it effectively into clinical practice. However, the current state of point-of-care US training in general surgery is inadequate. The Accreditation Council for Graduate Medical Education introduced the Milestones Project to evaluate resident and fellow performance. Emergency medicine is the only specialty with a point-of-care US milestone. We have successfully implemented a US training program into our general surgery residency curriculum and now propose milestones in point-of-care US for all general surgery residents.

show abstract

“…12 Hepatobiliary ultrasonography has been performed by surgeons in the emergency setting for nearly two decades. 12,14,15 The initial cost of procuring an ultrasound machine is also unlikely to be a hindrance given many emergency departments already employ them for difficult venous access, assessment of trauma and the critically unwell patient. 12,14,15 The initial cost of procuring an ultrasound machine is also unlikely to be a hindrance given many emergency departments already employ them for difficult venous access, assessment of trauma and the critically unwell patient.…”

Section: Introductionmentioning

confidence: 99%

Surgical ultrasonography at the bedside: a comparison of surgical trainees with trained sonographers for symptomatic cholelithiasis – a first Australian experience

Gaszynski

Lim

Chan

et al. 2018

ANZ Journal of Surgery

View full text Add to dashboard Cite

Background: Symptomatic cholelithiasis accounts for a significant burden of emergency general surgical presentations in Australia and the Western population. Access to hepatobiliary ultrasonography to facilitate diagnosis can lead to delays in timely treatment. Surgical ultrasonography at the bedside (SUB) can mitigate this barrier to patient care. This study assessed the diagnostic accuracy of SUB by trainees versus formal ultrasonographer or computed tomography examination for suspected symptomatic cholelithiasis. Methods: A prospective non-inferiority study of emergency patient admissions with abdominal pain in two tertiary referral hospitals during July 2017 to October 2018 was performed. Results of SUB were compared with accredited radiographer ultrasonography or computed tomography and histopathological assessment. Positive findings at SUB for symptomatic cholelithiasis included: cholelithiasis, gallbladder wall thickness 3 mm, pericholecystic fluid or sonographic Murphy's sign. Results: One hundred patients with epigastric or right upper quadrant pain underwent SUB. Mean patient age was 49 years (range 20-90 years), with 61 females and 39 males. Sensitivity and specificity for diagnosis of symptomatic cholelithiasis was 94.9% and 100% for SUB and 98.7% and 100% for accredited radiographers. Diagnostic accuracy was 96% for SUB and 99% for radiographer ultrasonography. Positive predictive value and negative predictive value were 100% and 84.6% for SUB and 100% and 96% for radiographers. The inter-rater reliability for features compatible with the diagnosis of symptomatic cholelithiasis was good with a kappa of 0.758 (95% confidence interval 0.587-0.929, P < 0.001). Conclusion: This first Australian experience demonstrates that general surgical trainees can accurately diagnose cholecystitis with SUB and this assessment is not inferior and has substantial agreement with accredited radiographer ultrasonography.

show abstract

Point of use ultrasound by general surgeons: Review of the literature and suggestions for future practice

Abstract: Evidence exists for the routine use of certain types of bedside ultrasound in surgical practice, especially in hepatobiliary and head and neck scanning. Further study is needed to determine its utility in vascular, hernia and breast ultrasound.

Cited by 33 publications

References 36 publications

The surgeon-performed ultrasound: a curriculum to improve residents’ basic ultrasound knowledge

The surgeon-performed ultrasound: a curriculum to improve residents’ basic ultrasound knowledge

Point‐of‐Care Ultrasound in General Surgery Residency Training: A Proposal for Milestones in Graduate Medical Education Ultrasound

Surgical ultrasonography at the bedside: a comparison of surgical trainees with trained sonographers for symptomatic cholelithiasis – a first Australian experience

Contact Info

Product

Resources

About