Trauma Ultrasound Workshop Improves Physician Detection of Peritoneal and Pericardial Fluid

Ali, Jameel; Rozycki, Grace S.; Campbell, Joan P.; Boulanger, Bernard R.; Jp, Waddell; Gana, Theophilus J.

doi:10.1006/jsre.1996.0260

Cited by 35 publications

(22 citation statements)

References 6 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In addition, they were asked to assess the presence of factors that may have limited their ability to perform or interpret the EUS examination, such as an uncooperative patient, the location of the lesion, or suspected pain from the examination. Overall, our training curriculum was comparable in length and design to other focused training programs described in the literature [7][8][9][10][11][12][13] and was consistent with the length and format recommended by ACEP. 2 Study physicians recorded video clips and still images (with caliper measurements if an abscess was identified) in two orthogonal planes on every lesion.…”

Section: Educational Interventionsupporting

confidence: 60%

Assessment of a Training Curriculum for Emergency Ultrasound for Pediatric Soft Tissue Infections

Marin

Panebianco

Dean

2011

Academic Emergency Medicine

View full text Add to dashboard Cite

Objectives: The objective was to evaluate a training protocol for pediatric emergency physicians (EPs) learning emergency ultrasound (EUS) for the evaluation of skin and soft tissue infections (SSTIs) by assessing technical ability and interrater reliability.Methods: Pediatric emergency medicine (EM) fellows and attending physicians completed a 1-day training course taught by an expert emergency sonologist. After the course, EPs performed proctored examinations on patients with SSTIs until they reached predefined performance criteria, after which they performed independent EUS examinations. All EUS examinations were recorded using still images and video clips that were reviewed and rated by the expert sonologist on four technical measures and combined into a composite score. The expert's opinion regarding the presence or absence of an abscess was also compared to the study sonologist's opinion and analyzed for interrater reliability.Results: Seven EPs performed 107 EUS examinations. The mean (±SD) composite score for the evaluation of technical ability for the first EUS was 3.3 ± 0.14 (on a 4-point scale), indicating a high level of quality following the training course. There was a small amount of improvement in the quality score (0.015, 95% confidence interval [CI] = 0.0003 to 0.03) with each consecutive EUS examination. The interrater reliability between the sonologist and the expert for the presence of an abscess as measured by the kappa statistic was 0.80 (95% CI = 0.63 to 0.97), indicating substantial agreement.

show abstract

Section: Educational Interventionsupporting

confidence: 60%

Assessment of a Training Curriculum for Emergency Ultrasound for Pediatric Soft Tissue Infections

Marin

Panebianco

Dean

2011

Academic Emergency Medicine

View full text Add to dashboard Cite

show abstract

“…There are a number of studies that suggest short educational programs, from four to eight hours in length, are sufficient to transmit the knowledge base and skills needed for the FAST exam. [13][14][15] The FAST educational curriculum should consist of both didactic instruction and practical instruction, although this varies depending on the sonographic experience of the trainees and availability of resources. The didactic instruction should include discussion of the general principles of sonography, the indications for performance of the FAST exam, and how to interpret the FAST exam.…”

Section: Trauma Sonographymentioning

confidence: 99%

“…The didactic instruction should include discussion of the general principles of sonography, the indications for performance of the FAST exam, and how to interpret the FAST exam. [13][14][15] In addition to still photographic images of different components of the FAST exam, video reviews of actual cases are helpful educational adjuncts to didactic education. 14 The necessity of obtaining accurate high-quality FAST images underscores the importance of hands-on in addition to didactic instruction.…”

Section: Trauma Sonographymentioning

confidence: 99%

“…Educators at an ATLS course in Toronto improved the ability of surgical residents and trauma physicians to detect intraperitoneal and pericardial fluid with a FAST workshop which included hands-on teaching of skills using normal patient models. 13 Conversely, an expert panel of trauma ultrasound educators on behalf of the ACS believed that while normal models are important adjuncts for training, trainees should also be required to be exposed to a minimum but unstated number of positive exams in order to demonstrate the ability to detect pathologic features.…”

Section: Normal Modelsmentioning

confidence: 99%

“…The duration of the didactic and practical course may vary depending on the experience of the trainees; conversely, both EM and surgical FAST educators have shown that the educational phase, both didactic and practical, can be accomplished in four to eight hours. [13][14][15] Although there is debate about the number of proctored exams required prior to certification as noted in Table 1, 20 to 50 exams is the most likely range and has been suggested by both EM and surgical series. The number of proctored exams could potentially be combined with the exams carried out in the practical phase of the education curriculum.…”

Section: Recommendations For Training and Credentialingmentioning

confidence: 99%

See 2 more Smart Citations

The Focused Abdominal Sonography for Trauma (FAST) Examination: Considerations and Recommendations for Training Physicians in the Use of a New Clinical Tool

Salen

Melanson

Heller

2000

Academic Emergency Medicine

View full text Add to dashboard Cite

Abstract. Focused abdominal sonography for trauma (FAST) is being used by growing numbers of emergency physicians and surgeons because it has proven to be an accurate, rapid, and repeatable bedside test for evaluating abdominal trauma victims. Controversy exists about the optimal means of FAST education and the number of examinations necessary to demonstrate competency. Most FAST educators agree that FAST education should consist of three phases: didactic, practical, and experiential. This article summarizes options and preliminary recommendations suitable for developing a FAST curriculum. Key words: abdominal; sonography; trauma; intraperitoneal; training; ultrasound; FAST; focused abdominal sonography for trauma; curriculum. ACA-DEMIC EMERGENCY MEDICINE 2000; 7:162-168 T HE MAJORITY of patients suffering significant blunt abdominal trauma (BAT) will require diagnostic peritoneal lavage (DPL) or an abdominal imaging modality of some sort during the course of their evaluation.1 Focused abdominal sonography for trauma (FAST) has long been relied upon in many European centers to evaluate victims of abdominal trauma. Growing numbers of North American centers are using the FAST exam to determine which BAT patients require laparotomy, as it has been proven to be a highly accurate, rapid, and repeatable bedside test that has no contraindications or complications.2 Upon incorporating ultrasound into routine trauma care, the utilization of both DPL and computed tomography (CT) scanning may decrease dramatically, and this has been associated with a decreased cost of caring for trauma patients.3 Recognizing the importance of this technique, the American College of Emergency Physicians (ACEP), the American Board of Emergency Medicine (ABEM), and the Society for Academic Emergency Medicine (SAEM) have included trauma ultrasound as part of the core content for emergency medicine (EM). 4A major issue in incorporating the FAST exam into the care provided by any emergency department (ED) or trauma center is the appropriate training of physicians in this skill. Although recent research has given insight about how to train physicians in this exam, issues of duration of training and number of exams necessary for credentialing remain contested. This article reviews the emerging role of the FAST exam, the amount of training and experience required for proficiency, and various models available for training in this skill. TRAUMA SONOGRAPHYThe FAST exam can be easily incorporated into the stabilization and resuscitation phase of care in the treatment of BAT patients. Many researchers have reported the amount of time required to perform this evaluation, and it is clear that the FAST exam can be completed within 5 minutes.2 The primary goal of the FAST exam is to determine whether blood is present in the peritoneal, pericardial, or pleural cavities. The FAST exam most commonly consists of four views: one cardiac window (subcostal view) and three abdominal windows (right upper quadrant, left upper quadrant, and pelvis) (Fig. 1). The ri...

show abstract

"Alternative" Surgery in Trauma Management

Britt¹

1998

Arch Surg

View full text Add to dashboard Cite

lternative" surgery in the trauma discipline essentially means nonoperative or a selective approach to the injured victim. Such an approach is a critical part of the trauma management options. However, it is unlikely that the term "alternative surgery" will be liberally used to depict this growing trend of nonoperative, selective, and minimally invasive trauma management because of its less than favorable connotations and biases with respect to alternative medicine. Although there are still clear indications for emergency operative intervention, the nonoperative or selective approach in both penetrating and blunt trauma is the state of the art.

show abstract

Trauma Ultrasound Workshop Improves Physician Detection of Peritoneal and Pericardial Fluid

Cited by 35 publications

References 6 publications

Assessment of a Training Curriculum for Emergency Ultrasound for Pediatric Soft Tissue Infections

Assessment of a Training Curriculum for Emergency Ultrasound for Pediatric Soft Tissue Infections

The Focused Abdominal Sonography for Trauma (FAST) Examination: Considerations and Recommendations for Training Physicians in the Use of a New Clinical Tool

"Alternative" Surgery in Trauma Management

Contact Info

Product

Resources

About