护士肺滑动检测:短期集中理论培训的影响

S. Mongodi, S. Bonaiti, Erminio Santangelo, A. Stella, R. Vaschetto, P. Borrelli, Attilio Quaini, G. Grugnetti, A. Massara, A. Grugnetti, F. Mojoli
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引用次数: 1

摘要

背景:肺超声可显著提高急性呼吸衰竭的鉴别诊断,特别是可通过肺滑动分析准确排除气胸[1]。护士经常独立评估呼吸窘迫患者;这种情况发生在创伤患者在院前现场由护士急救小组协助的情况下。目前,护士仅使用听诊,但在接受适当的培训后,可以使用超声提高其评估准确性[2]。目的:通过短期重点理论培训,检验护士提高肺滑动判读能力的可能性。方法:对大学一级危重监护硕士护士3小时重点培训前后25个片段(有无肺滑动、肺脉、肺点或无胸膜运动)进行分析。结果:共涉及22名护士学员(男4名,年龄26.0[24.0-28.0]岁,既往超声培训1次,既往肺超声培训0次),培训前后正确率中位数由0.5[0.0-2.0]变为8.5 [6.0-12.0](p)。结论:短时间的理论培训显著提高了护士肺滑动解释能力;然而,训练后准确答案的百分比仍然太低,无法用于临床,这表明更长时间的训练可能是有用的。本研究仅关注图像解译;没有测试图像获取所需的训练。引用:1。Laursen等人。柳叶刀呼吸医学2014;2:638-46;2. Noble VE等。BMC医学教育2009;9:3
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Lung sliding detection by nurses: impact of a short focused theoretical training
Background: Lung ultrasound significantly improves the differential diagnosis of acute respiratory failure and in particular allows ruling in or out pneumothorax by the analysis of lung sliding with high accuracy[1]. Nurses frequently assess patients with respiratory distress independently; this happens in case of trauma patients assisted by nurse-only emergency teams in pre-hospital field. So far nurses only used auscultation but may improve their assessment accuracy using ultrasound, after having received a proper training [2]. Aims and Objectives: to test the possibility to improve lung sliding interpretation by nurses with a short focused theoretical training. Methods: Interpretation of a slot of 25 clips (presence of lung sliding, lung pulse, lung point or no pleural movement) before and after a 3-hour focused training for nurses attending a first level university master in critical care. Results: 22 nurse trainees were involved (males 4, age 26.0 [24.0-28.0] year-old, previous ultrasound training 1, previous lung ultrasound training 0). From before to after the training, the median number of correct answers changed from 0.5 [0.0-2.0] to 8.5 [6.0-12.0] (p Conclusions: A short theoretical training significantly improved lung sliding interpretation by nurses; however, the percentage of exact answers after the training remained too low to allow clinical use, suggesting a longer training may be useful. The study only focused on image interpretation; the training required for image acquisition was not tested. References: 1. Laursen CB et al. Lancet Respir Med 2014;2:638-46; 2. Noble VE et al. BMC Medical Education 2009;9:3
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