Department of Emergency Medicine, Waikato Hospital, Pembroke Street, Hamilton, New Zealand.
Emerg Med Australas. 2010 Feb;22(1):30-4. doi: 10.1111/j.1742-6723.2009.01255.x. Epub 2010 Feb 4.
To assess the ability of emergency physicians and emergency trainees to detect soft tissue foreign bodies using typical ultrasound equipment.
Following a 20 min interactive training session, emergency physicians and emergency trainees were assessed on ability to identify subcutaneous foreign bodies (wood, glass, plastic, gravel and metal) embedded in an experimental model containing both sham and real entry point incisions. In the second phase of the experiment accuracy of detection of multiple foreign bodies was assessed in a similar sonographic phantom.
Six emergency physicians and 14 emergency trainees performed a total of 400 individual sonographic examinations. Emergency physicians correctly identified 29 of 30 foreign bodies and returned sensitivity, specificity, positive predictive value and negative predictive value of 96.7%, 70%, 76.3% and 95.5%, respectively. Trainees correctly identified 60 of 70 foreign bodies and returned sensitivity, specificity, positive predictive value and negative predictive value of 85.7%, 82.9%, 83.3% and 85.3%. Correct identification of the number of foreign bodies present, when multiple, was low (25% physician vs 36% trainee).
These data suggest ultrasound in the hands of emergency doctors might be useful as an initial screening tool for detection of soft tissue foreign bodies.
评估急诊医师和急诊实习生使用典型超声设备检测软组织异物的能力。
在进行 20 分钟的互动培训课程后，评估急诊医师和急诊实习生识别嵌入实验模型中的皮下异物（木、玻璃、塑料、砾石和金属）的能力，该模型既有模拟入口切口，也有真实入口切口。在实验的第二阶段，在类似的超声体模中评估了检测多个异物的准确性。
6 名急诊医师和 14 名急诊实习生总共进行了 400 次单独的超声检查。急诊医师正确识别了 30 个异物中的 29 个，其敏感性、特异性、阳性预测值和阴性预测值分别为 96.7%、70%、76.3%和 95.5%。实习生正确识别了 70 个异物中的 60 个，其敏感性、特异性、阳性预测值和阴性预测值分别为 85.7%、82.9%、83.3%和 85.3%。当存在多个异物时，正确识别异物数量的能力较低（医师为 25%，实习生为 36%）。
这些数据表明，在急诊医生手中，超声可能是一种有用的初步筛查工具，用于检测软组织异物。
