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法国急诊室和院前环境中床边超声实践的可及性变化。

Changes in the availability of bedside ultrasound practice in emergency rooms and prehospital settings in France.

机构信息

Pôle anesthésie réanimation douleur urgence, CHU de Nîmes, place du Pr-Debré, 30029 Nîmes, France.

Samu-Smur urgence (PHU3), CHU de Nantes, 1, Quai Moncousu, 44093 Nantes cedex 01, France.

出版信息

Anaesth Crit Care Pain Med. 2018 Jun;37(3):201-205. doi: 10.1016/j.accpm.2017.06.008. Epub 2017 Aug 4.

Abstract

OBJECTIVE

Ensuring the availability of ultrasound devices is the initial step in implementing clinical ultrasound (CUS) in emergency services. In France in 2011, 52% of emergency departments (EDs) and only 9% of mobile intensive care stations (MICS) were equipped with ultrasound devices. The main goal of this study was to determine the movement of these rates since 2011.

METHODS

We conducted a cross-sectional, descriptive, multicentre study in the form of a questionnaire. To estimate the numbers of EDs and MICS equipped with at least one ultrasound system with a confidence level of 95% and margin of error of 5%, 170 responding EDs and 145 MICS were required. Each service was solicited three times by secure online questionnaire and then by phone.

RESULTS

Three hundred and twenty-eight (84%) services responded to the questionnaire: 179 (86%) EDs and 149 (82%) MICS. At least one ultrasound machine was available in 127 (71%, 95% CI [64; 78]) EDs vs. 52% in 2011 (P<0.01). 42 (28%, 95% CI [21; 35]) MICS were equipped vs. 9% in 2011 (P<0.01). In 97 (76%) EDs and 24 (55%) MICS, less than a half of physicians were trained. CUS was used at least three times a day in 52 (41%) EDs and in 8 (19%) MICS.

CONCLUSION

Our study demonstrates improved access to ultrasound devices in French EDs and MICS. Almost three-quarters of EDs and nearly one-third of MICS are now equipped with at least one ultrasound device. However, the rate of physicians trained per service remains insufficient.

摘要

目的

确保超声设备的可用性是在急救服务中实施临床超声(CUS)的第一步。2011 年,法国 52%的急诊部(ED)和仅 9%的移动重症监护站(MICS)配备了超声设备。本研究的主要目的是确定自 2011 年以来这些比率的变化情况。

方法

我们进行了一项横断面、描述性、多中心的问卷调查研究。为了在 95%的置信水平和 5%的误差幅度下估计配备至少一个超声系统的 ED 和 MICS 的数量,需要 170 个响应的 ED 和 145 个 MICS。每个服务通过安全的在线问卷进行了三次调查,然后通过电话进行了调查。

结果

328 个(84%)服务对问卷做出了回应:179 个(86%)ED 和 149 个(82%)MICS。127 个(71%,95%置信区间[64; 78])ED 至少配备了一台超声机,而 2011 年为 52%(P<0.01)。42 个(28%,95%置信区间[21; 35])MICS 配备了设备,而 2011 年为 9%(P<0.01)。在 97 个(76%)ED 和 24 个(55%)MICS 中,不到一半的医生接受了培训。至少每天在 52 个(41%)ED 和 8 个(19%)MICS 中使用 CUS 三次以上。

结论

我们的研究表明,法国 ED 和 MICS 获得超声设备的机会有所增加。近四分之三的 ED 和近三分之一的 MICS 现在配备了至少一台超声设备。然而,每个服务的受过培训的医生人数仍然不足。

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