Udrea Daniel S, Sumnicht Andrew, Lo Deanna, Villarreal Logan, Gondra Stephanie, Chyan Richard, Wisham Audra, Dinh Vi Am
School of Medicine, Loma Linda University, Loma Linda, California.
Department of Emergency Medicine, Loma Linda University, Loma Linda, California.
J Emerg Med. 2017 Jul;53(1):102-109. doi: 10.1016/j.jemermed.2017.01.021. Epub 2017 Mar 3.
Despite the increasing integration of ultrasound training into medical education, there is an inadequate body of research demonstrating the benefits and practicality of medical student-performed point-of-care ultrasound (SP-POCUS) in the clinical setting.
The primary purpose of this study was to evaluate the effects that SP-POCUS can have on physician diagnosis and management of patients in the emergency department, with a secondary purpose of evaluating the diagnostic accuracy of SP-POCUS.
SP-POCUS examinations were performed in the emergency department by medical students who completed year one of a 4-year medical school curriculum with integrated ultrasound training. Scans were evaluated by an emergency physician who then completed a survey to record any changes in diagnosis and management.
A total of 641 scans were performed on the 482 patients enrolled in this study. SP-POCUS resulted in a change in management in 17.3% of scans performed. For 12.4% of scans, SP-POCUS discovered a new diagnosis. SP-POCUS reduced time to disposition 33.5% of the time. Because of SP-POCUS, physicians avoided ordering an additional imaging study for 53.0% of the scans performed. There was 94.7% physician agreement with SP-POCUS diagnosis.
This study showed that SP-POCUS is feasible and may potentially have a meaningful impact on physician diagnosis and management of patients in the emergency department. In addition, the implementation of SP-POCUS could serve as an ideal method of developing ultrasound skills in medical school while positively impacting patient care.
尽管超声培训在医学教育中的融入日益增加,但仍缺乏足够的研究来证明医学生进行的床旁超声检查(SP-POCUS)在临床环境中的益处和实用性。
本研究的主要目的是评估SP-POCUS对急诊科医生对患者的诊断和管理的影响,次要目的是评估SP-POCUS的诊断准确性。
完成了四年制医学院课程第一年并接受了综合超声培训的医学生在急诊科进行SP-POCUS检查。扫描结果由一名急诊医生进行评估,然后该医生完成一项调查以记录诊断和管理方面的任何变化。
本研究纳入的482名患者共进行了641次扫描。SP-POCUS导致17.3%的扫描在管理方面发生了变化。在12.4%的扫描中,SP-POCUS发现了新的诊断。SP-POCUS在33.5%的情况下缩短了处置时间。由于SP-POCUS,医生在53.0%的扫描中避免了额外的影像学检查。医生对SP-POCUS诊断的认同率为94.7%。
本研究表明,SP-POCUS是可行的,并且可能对急诊科医生对患者的诊断和管理产生有意义的影响。此外,实施SP-POCUS可以作为在医学院培养超声技能的理想方法,同时对患者护理产生积极影响。