Division of Emergency Medicine, Washington University School of Medicine, St. Louis, MO, USA.
Acad Emerg Med. 2012 Jan;19(1):98-101. doi: 10.1111/j.1553-2712.2011.01242.x. Epub 2011 Dec 23.
The objective was to assess the incidence of various technical errors committed by emergency physicians (EPs) learning to perform focused assessment with sonography in trauma (FAST).
This was a retrospective review of the first 75 consecutive FAST exams for each EP from April 2000 to June 2005. Exams were assessed for noninterpretable views, misinterpretation of images, poor gain, suboptimal depth, an incomplete exam, or backward image orientation.
A total of 2,223 FAST exams done by 85 EPs were reviewed. Multiple noninterpretable views or misinterpreted images occurred in 24% of exams for those performing their first 10 exams, 3.6% for those performing their 41st to 50th exams, and 0% for those performing their 71st to 75th exams (Cochran-Armitage trend test = 10.5, p < 0.0001). A single noninterpretable view, poor gain, suboptimal depth, incomplete exam, or backward image orientation occurred in 48% of exams for those performing their first 10 exams, 17% for those performing their 41st to 50th exams, and 5% for those performing their 71st to 75th exams (Cochran-Armitage trend test = 11.6, p < 0.0001).
The incidence of specific technical errors of EPs learning to perform FAST at our institution improved with hands-on experience. Interpretive skills improved more rapidly than image acquisition skills.
评估急诊医师（EP）在学习进行创伤重点超声评估（FAST）时出现的各种技术错误的发生率。
这是对 2000 年 4 月至 2005 年 6 月期间每位 EP 进行的前 75 次连续 FAST 检查的回顾性分析。检查评估了不可读视图、图像误读、增益不佳、深度不佳、检查不完整或图像反向等情况。
共回顾了 2223 次由 85 名 EP 进行的 FAST 检查。对于前 10 次检查的 EP，24%的检查存在多个不可读视图或图像误读，第 41 至 50 次检查的 EP 为 3.6%，第 71 至 75 次检查的 EP 为 0%（Cochran-Armitage 趋势检验=10.5，p<0.0001）。对于前 10 次检查的 EP，48%的检查存在单个不可读视图、增益不佳、深度不佳、检查不完整或图像反向，第 41 至 50 次检查的 EP 为 17%，第 71 至 75 次检查的 EP 为 5%（Cochran-Armitage 趋势检验=11.6，p<0.0001）。
在我们的机构中，EP 学习进行 FAST 时出现的特定技术错误的发生率随着实践经验的增加而降低。解读技能的提高速度快于图像采集技能。
