Ahern Brian J, Monti Jonathan D, Naylor Jason F, Cronin Aaron J, Perreault Michael D
Madigan Army Medical Center, 9040 Jackson Avenue, Joint Base Lewis-McChord, WA 98431.
The Henry M. Jackson Foundation for the Advancement of Military Medicine Inc., 9040 Jackson Avenue, Madigan Army Medical Center, Joint Base Lewis-McChord, WA 98431.
Mil Med. 2020 Jan 7;185(Suppl 1):19-24. doi: 10.1093/milmed/usz277.
Point-of-injury extended focused assessment with sonography in trauma (eFAST) may identify life-threatening torso hemorrhage and expedite casualty evacuation. The purpose of this study was to compare combat medic eFAST performance between the novel and conventional ultrasound (US) transducers.
We conducted a randomized crossover trial. Medic participants, previously naïve to US, were randomized to the type of transducer first utilized. The primary outcome was eFAST completion time in seconds. Secondary outcomes included diagnostic accuracy, technical adequacy, and transducer ease-of-use rating.
Forty medics performed 160 eFASTs. We found a statistically significant difference in eFAST completion times in favor of conventional transducers (304 vs. 358 s; P = 0.03). There was no statistically significant difference between the conventional and novel transducers in terms of diagnostic accuracy (97.7% vs. 96.0%; P = 0.25) and technical adequacy (65% vs. 72.5%; P = 0.11). Median transducer ease-of-use rating (Likert 1-5 scale) was statistically significant in favor of the conventional transducers (5 vs. 4; P = < 0.001).
Extended focused assessment with sonography in trauma exam times was faster with the conventional transducers. Combat medics performed diagnostically accurate eFASTs with both transducer types in a simulated aid station setting after a brief training intervention. Conventional transducers were rated higher for ease-of-use.
创伤现场超声重点评估（eFAST）可识别危及生命的躯干出血并加快伤员后送。本研究的目的是比较新型与传统超声（US）换能器在战斗医护人员进行eFAST检查时的表现。
我们进行了一项随机交叉试验。此前未接触过超声的医护人员参与者被随机分配首先使用的换能器类型。主要结局是以秒为单位的eFAST完成时间。次要结局包括诊断准确性、技术充分性和换能器易用性评分。
40名医护人员进行了160次eFAST检查。我们发现eFAST完成时间在统计学上有显著差异，传统换能器更具优势（304秒对358秒；P = 0.03）。在诊断准确性（97.7%对96.0%；P = 0.25）和技术充分性（65%对72.5%；P = 0.11）方面，传统换能器与新型换能器之间无统计学显著差异。换能器易用性评分中位数（李克特1 - 5级量表）在统计学上有显著差异，传统换能器更具优势（5分对4分；P = <0.001）。
使用传统换能器进行创伤超声重点评估的检查时间更快。经过简短的培训干预后，战斗医护人员在模拟救助站环境中使用两种换能器类型均能进行诊断准确的eFAST检查。传统换能器在易用性方面评分更高。
