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在临床实践中,初级医生将超声用作辅助外周静脉置管的手段。

The use of ultrasound as an adjunct to peripheral venous cannulation by junior doctors in clinical practice.

机构信息

a Department of Intensive Care , Blackpool Teaching Hospitals NHS Foundation Trust , Blackpool , UK.

出版信息

Med Teach. 2018 Dec;40(12):1275-1280. doi: 10.1080/0142159X.2018.1428737. Epub 2018 Jan 31.

Abstract

PURPOSE

There is little consensus on the role of training in bedside ultrasound skills for medical students or junior doctors early in their careers.

METHODS

We trained 20 Foundation Year 1 doctors in the use of ultrasound as an adjunct to peripheral venous cannulation and following an assessment of competence gave them access to an ultrasound machine to assist with difficult cannulations in their clinical practice. Self-reported confidence and competence were assessed using pre- and post-training questionnaires, with competence objectively assessed immediately post-training and at one and three months follow up. Clinical use of ultrasound was studied over three months.

RESULTS

Improvements in self-reported confidence and competence were observed post-training and retained at three months. 85% (17/20) of participants were objectively assessed as competent immediately post-training, with retention of competence demonstrated in 80% (16/20) and 75% (15/20) at one and three months, respectively. There were 33 separate uses of ultrasound during the three month study period with a 73% (24/33) success rate and no adverse incidents.

CONCLUSIONS

We suggest that doctors in their first post-graduate year can be trained in the use of ultrasound as an adjunct to peripheral venous cannulation, retain the skill over time and use it safely in their clinical practice.

摘要

目的

对于医学生或初级医生来说,在职业生涯早期,培训在床边超声技能中的作用尚未达成共识。

方法

我们培训了 20 名第一年住院医师使用超声作为辅助外周静脉穿刺的方法,在评估其能力后,允许他们在临床实践中使用超声机辅助进行困难的穿刺。使用培训前后的问卷评估自我报告的信心和能力,在培训后即刻以及一个月和三个月随访时进行客观评估。在三个月的时间里研究了超声的临床应用。

结果

培训后自我报告的信心和能力有所提高,并在三个月时保持不变。20 名参与者中有 85%(17/20)在培训后即刻被客观评估为熟练,分别有 80%(16/20)和 75%(15/20)在一个月和三个月时保留了熟练程度。在三个月的研究期间,共进行了 33 次单独的超声使用,成功率为 73%(24/33),无不良事件发生。

结论

我们认为,在毕业后的第一年,医生可以接受超声作为外周静脉穿刺辅助工具的培训,随着时间的推移,他们可以保留这项技能,并在临床实践中安全使用。

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