College of Medicine and Veterinary Medicine, University of Edinburgh, Edinburgh, UK.
Emerg Med J. 2013 Feb;30(2):112-6. doi: 10.1136/emermed-2011-201028. Epub 2012 Mar 6.
Firstly, to detail the experiences of one UK training region in establishing an emergency ultrasound (EU) training programme and secondly, to report the initial 30 months of EU scanning experience.
Prospective study of all documented emergency department (ED) ultrasound scans. Results were extracted from written paper reports and/or electronically saved images. Details of scan date, time, type of scan, grade of operator, supervision status (whether supervised by a level 1 competent scanner) and whether the scan was clinical (performed or supervised by a level 1 operator) or training, were recorded. EU scans were reviewed for quality (internal quality assurance) and for diagnostic accuracy (external quality assurance).
Between 14 January 2009 and 4 July 2011, 626 scans were performed by 41 operators. 263 (42%) scans were completed outside of normal working hours (09:00 to 17:00). There were 251 abdominal aorta and inferior vena cava scans (40% of all scans) and 198 focused assessment with sonography in trauma scans (32%). The number of scans performed by each operator varied widely. 87 scans (14%) were supervised but the majority (459; 73%) were not. 484 (77%) scans were for training purposes, 124 (20%) were clinical scans and the majority (401; 63%) were performed by either speciality registrars (ST4-6) or specialist registrars (SpR). When the three commonest types of scans performed were analysed, eight false positives and 11 false negatives were identified. Only seven of these were deemed of poor quality and none led to poor patient outcome.
Since the acquisition of our ED ultrasound machine and the development of a quality assured training programme, on average 20 scans per month have been performed in the ED, with no known adverse patient outcomes.
首先，详细介绍英国一个培训地区建立急诊超声（EU）培训计划的经验，其次，报告 EU 扫描的最初 30 个月经验。
对所有记录在案的急诊科超声扫描进行前瞻性研究。结果从书面报告和/或电子保存的图像中提取。记录扫描日期、时间、扫描类型、操作人员级别、监督状态（是否由 1 级合格扫描仪监督）以及扫描是临床（由 1 级操作人员执行或监督）还是培训。评估 EU 扫描的质量（内部质量保证）和诊断准确性（外部质量保证）。
在 2009 年 1 月 14 日至 2011 年 7 月 4 日期间，由 41 名操作人员完成了 626 次扫描。263 次（42%）扫描在正常工作时间（09:00 至 17:00）之外完成。有 251 次腹部主动脉和下腔静脉扫描（所有扫描的 40%）和 198 次创伤焦点评估超声扫描（32%）。每个操作人员执行的扫描数量差异很大。87 次扫描（14%）得到监督，但大多数（459 次；73%）未得到监督。484 次扫描（77%）是为培训目的，124 次扫描（20%）是临床扫描，大多数（401 次；63%）是由专科住院医师（ST4-6）或专科住院医师（SpR）执行的。当分析执行的三种最常见类型的扫描时，发现了 8 个假阳性和 11 个假阴性。只有其中的 7 个被认为质量较差，没有一个导致患者不良后果。
自获得急诊科超声机并建立质量保证培训计划以来，急诊科平均每月进行 20 次扫描，没有已知的不良患者结局。
