Department of Anesthesia and Pain Management, Mount Sinai Hospital and University of Toronto, 600 University Avenue, Room 19-104, Toronto, ON, M5G 1X5, Canada.
Can J Anaesth. 2013 Aug;60(8):771-9. doi: 10.1007/s12630-013-9974-y. Epub 2013 May 24.
Focused assessment of the gastric antrum by ultrasound is a feasible tool to evaluate the quality of the stomach content. We aimed to determine the amount of training an anesthesiologist would need to achieve competence in the bedside ultrasound technique for qualitative assessment of gastric content.
Six anesthesiologists underwent a teaching intervention followed by a formative assessment; then learning curves were constructed. Participants received didactic teaching (reading material, picture library, and lecture) and an interactive hands-on workshop on live models directed by an expert sonographer. The participants were instructed on how to perform a systematic qualitative assessment to diagnose one of three distinct categories of gastric content (empty, clear fluid, solid) in healthy volunteers. Individual learning curves were constructed using the cumulative sum method, and competence was defined as a 90% success rate in a series of ultrasound examinations. A predictive model was further developed based on the entire cohort performance to determine the number of cases required to achieve a 95% success rate.
Each anesthesiologist performed 30 ultrasound examinations (a total of 180 assessments), and three of the six participants achieved competence. The average number of cases required to achieve 90% and 95% success rates was estimated to be 24 and 33, respectively.
With appropriate training and supervision, it is estimated that anesthesiologists will achieve a 95% success rate in bedside qualitative ultrasound assessment after performing approximately 33 examinations.
超声对胃窦的重点评估是一种可行的工具，可用于评估胃内容物的质量。我们旨在确定麻醉师需要多少培训才能掌握床边超声技术，以进行胃内容物的定性评估。
六名麻醉师接受了教学干预和形成性评估；然后构建了学习曲线。参与者接受了理论教学（阅读材料、图片库和讲座）以及由专家超声医师指导的现场模型互动实践工作坊。参与者接受了如何进行系统的定性评估以诊断健康志愿者胃内容物（空、清亮液体、固体）的三种不同类别的指示。使用累积和方法构建个体学习曲线，并且将 90%的成功率定义为一系列超声检查中的成功率。进一步基于整个队列的表现开发了预测模型，以确定达到 95%成功率所需的病例数。
每位麻醉师进行了 30 次超声检查（总共 180 次评估），六名参与者中有三名达到了能力水平。估计达到 90%和 95%成功率所需的平均病例数分别为 24 和 33。
经过适当的培训和监督，估计麻醉师在进行大约 33 次检查后，将在床边定性超声评估中达到 95%的成功率。
