Emergency Department, Laveran Army Training Hospital, 34, boulevard Laveran, BP 60149, 13384 Marseille cedex 13, France.
Diagn Interv Imaging. 2013 Nov;94(11):1109-15. doi: 10.1016/j.diii.2013.04.016. Epub 2013 Aug 6.
To evaluate the feasibility of "accelerated" training for military doctors in front line ultrasound. To establish the number of ultrasounds required to validate the doctor's training. To assess the average acquisition time for each ultrasound target.
Prospective study on 10 novice generalist military doctors to assess training for five urgent ultrasound targets: focused assessment with sonography in trauma (FAST), pleura, bladder, abdominal aorta and gallbladder. Each student received theoretical and practical training on "healthy" people and then performed 10 timed ultrasounds in an emergency situation, the result of which was either confirmed or rejected by a nationally qualified ultrasound expert.
Some targets were easier to acquire (bladder, aorta and pleura) with excellent diagnostic performance after 10 ultrasounds on healthy people (sensitivity = 100%; specificity = 100%). The overall number of ultrasound errors fell over time. The median investigation time also fell significantly for all targets, reaching a plateau. Twenty ultrasounds including 10 "real life" appear to be needed for FAST. A minimum number of 30 ultrasounds is required to diagnose acute cholecystitis.
"Accelerated" training for generalist military doctors in front line ultrasound is achievable. The recommended number of 25 ultrasounds per target is not appropriate for all ultrasound targets.
评估前线超声医师“加速”培训的可行性。确定验证医生培训所需的超声检查数量。评估每个超声目标的平均采集时间。
对 10 名新手通科军医进行前瞻性研究，以评估对 5 个紧急超声目标的培训：创伤超声重点评估（FAST）、胸膜、膀胱、腹主动脉和胆囊。每位学生都接受了关于“健康”人群的理论和实践培训，然后在紧急情况下进行了 10 次计时超声检查，结果由具有国家资质的超声专家确认或否定。
某些目标更容易获得（膀胱、主动脉和胸膜），在对 10 名健康人进行超声检查后具有出色的诊断性能（敏感度=100%；特异性=100%）。随着时间的推移，超声检查的错误总数下降。所有目标的中位检查时间也显著下降，并达到平台期。包括 10 次“真实生活”在内的 20 次超声检查似乎足以诊断 FAST。诊断急性胆囊炎至少需要 30 次超声检查。
前线超声通科军医的“加速”培训是可行的。每个目标推荐 25 次超声检查的数量并不适用于所有超声目标。
