Jacob Mary, Shokoohi Hamid, Moideen Fabith, Pousson Amelia, Boniface Keith
Department of Emergency Medicine, George Washington University, Washington DC. USA.
Department of Emergency Medicine, Baby Memorial Hospital, Calicut, Kerala, India.
Emerg (Tehran). 2017;5(1):e70. Epub 2017 Jun 15.
Focused training in transthoracic echocardiography enables emergency physicians (EPs) to accurately estimate the left ventricular function. This study aimed to evaluate the efficacy of a brief training program utilizing standardized echocardiography video clips in this regard.
A before and after design was used to determine the efficacy of a 1 hour echocardiography training program using PowerPoint presentation and standardized echocardiography video clips illustrating normal and abnormal left ventricular ejection fraction (LVEF) as well as video clips emphasizing the measurement of mitral valve E-point septal separation (EPSS). Pre- and post-test evaluation used unique video clips and asked trainees to estimate LVEF and EPSS based on the viewed video clips.
21 EPs with no prior experience with the echocardiographic technical methods completed this study. The EPs had very limited prior echocardiographic training. The mean score on the categorization of LVEF estimation improved from 4.9 (95% CI: 4.1-5.6) to 7.6 (95%CI: 7-8.3) out of a possible 10 score (p<0.0001). Categorization of EPSS improved from 4.1 (95% CI: 3.1-5.1) to 8.1 (95% CI: 7.6- 8.7) after education (p<0.0001).
The results of this study demonstrate a statistically significant improvement of EPs' ability to categorize left ventricular function as normal or depressed, after a short lecture utilizing a commercially available DVD of standardized echocardiography clips.
经胸超声心动图的集中培训能使急诊医生准确评估左心室功能。本研究旨在评估在这方面利用标准化超声心动图视频片段的简短培训项目的效果。
采用前后设计来确定使用PowerPoint演示文稿以及展示正常和异常左心室射血分数(LVEF)的标准化超声心动图视频片段,还有强调二尖瓣E点-室间隔距离(EPSS)测量的视频片段进行1小时超声心动图培训项目的效果。测试前和测试后的评估使用独特的视频片段,并要求学员根据所观看的视频片段估计LVEF和EPSS。
21名此前没有超声心动图技术方法经验的急诊医生完成了本研究。这些急诊医生之前接受的超声心动图培训非常有限。LVEF估计分类的平均得分从可能的10分中的4.9分(95%置信区间:4.1 - 5.6)提高到7.6分(95%置信区间:7 - 8.3)(p<0.0001)。教育后EPSS的分类从4.1分(95%置信区间:3.1 - 5.1)提高到8.1分(95%置信区间:7.6 - 8.7)(p<0.0001)。
本研究结果表明,在使用市售标准化超声心动图片段DVD进行简短讲座后,急诊医生对左心室功能分类为正常或降低的能力有统计学上的显著提高。