Focused transesophageal echocardiography for emergency physicians-description and results from simulation training of a structured four-view examination.

IF 3.6 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Critical Ultrasound Journal Pub Date : 2015-12-01 Epub Date: 2015-06-12 DOI:10.1186/s13089-015-0027-3
Robert Arntfield, Jacob Pace, Shelley McLeod, Jeff Granton, Ahmed Hegazy, Lorelei Lingard
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引用次数: 60

Abstract

Background: Transesophageal echocardiography (TEE) offers several advantages over transthoracic echocardiography (TTE). Despite these advantages, use of TEE by emergency physicians (EPs) remains rare, as no focused TEE protocol for emergency department (ED) use has been defined nor have methods of training been described.

Objective: This study aims to develop a focused TEE examination tailored for the ED and to evaluate TEE skill acquisition and retention by TEE-naïve EPs following a focused 4-h curriculum.

Methods: Academic EPs were invited to participate in a 4-h didactic and simulation-based workshop. The seminar emphasized TEE principles and views obtained from four vantage points. Following the training, participants engaged in an assessment of their abilities to carry out a focused TEE on a high-fidelity simulator. A 6-week follow-up session assessed skill retention.

Results: Fourteen EPs participated in this study. Immediately following the seminar, 14 (100 %; k = 1.0) and 10 (71.4 %, k = 0.65) successfully obtained an acceptable mid-esophageal four-chamber and mid-esophageal long-axis view. Eleven (78.6 %, k = 1.0) participants were able to successfully obtain an acceptable transgastric short-axis view, and 11 (78.6 %, k = 1.0) EPs successfully obtained a bicaval view. Twelve participants engaged in a 6-week retention assessment, which revealed acceptable images and inter-rater agreement as follows: mid-esophageal four-chamber, 12 (100 %; k = 0.92); mid-esophageal long axis, 12 (100 %, k = 0.67); transgastric short-axis, 11 (91.7 %, k = 1.0); and bicaval view, 11 (91.7 %, k = 1.0).

Conclusion: This study has illustrated that EPs can successfully perform this focused TEE protocol after a 4-h workshop with retention of these skills at 6 weeks.

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针对急诊医师的经食管超声心动图-结构化四视图检查模拟训练的描述和结果。
背景:经食管超声心动图(TEE)比经胸超声心动图(TTE)有几个优势。尽管有这些优势,急诊医生(EPs)使用TEE仍然很少,因为没有针对急诊科(ED)使用的重点TEE协议被定义,也没有描述培训方法。目的:本研究旨在为ED量身定制一个重点TEE考试,并评估TEE-naïve EPs在重点4小时课程后TEE技能的获得和保留。方法:邀请学术EPs参加为期4小时的教学和模拟研讨会。研讨会强调了TEE原则和从四个有利角度获得的观点。培训结束后,参与者对他们在高保真模拟器上进行集中TEE的能力进行了评估。为期6周的随访评估了技能保留情况。结果:14例EPs参与本研究。研讨会结束后,14 (100%;K = 1.0)和10 (71.4%,K = 0.65)成功获得了可接受的中食道四室和中食道长轴视图。11名(78.6%,k = 1.0)参与者能够成功获得可接受的经胃短轴视图,11名(78.6%,k = 1.0) EPs成功获得双轴视图。12名参与者进行了为期6周的保留评估,结果显示可接受的图像和评分间的一致性如下:食管中期四腔,12 (100%;K = 0.92);食管中长轴12例(100%,k = 0.67);经胃短轴11例(91.7%,k = 1.0);双元视图为11 (91.7%,k = 1.0)。结论:本研究表明,EPs可以在4小时的工作坊后成功执行这种专注的TEE方案,并在6周时保留这些技能。
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来源期刊
Critical Ultrasound Journal
Critical Ultrasound Journal RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING-
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审稿时长
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