Section of Pediatric Emergency Medicine, Department of Pediatrics, Yale University School of Medicine, New Haven, CT.
Section of Pediatric Emergency Medicine, Department of Pediatrics, Yale University School of Medicine, New Haven, CT; Department of Emergency Medicine, Yale University School of Medicine, New Haven, CT.
Air Med J. 2022 Mar-Apr;41(2):222-227. doi: 10.1016/j.amj.2021.11.002. Epub 2021 Dec 9.
Point-of-care ultrasound (POCUS) is used to manage patients in real time. This study aimed to teach pediatric critical care team members to use POCUS for endotracheal tube (ETT) placement confirmation. A secondary aim was to assess the feasibility of a remote curriculum for this purpose.
The Kern 6-step approach was used. The curriculum involved virtual didactics, asynchronous learning modules, and remote hands-on sessions using teleguidance with the Butterfly IQ+ probe, Butterfly Network, Inc, Guilford, CT. Participants learned direct and indirect methods of ETT placement confirmation and were directed to practice independently. Outcomes included attitudes and satisfaction, knowledge and skills acquisition and retention, and the use of POCUS on shift.
Ten participants completed the curriculum. The average knobology and quiz scores improved by 29.3% and 20.8%, respectively. Improvement was sustained at re-evaluation. Seven of 10 participants performed independent scans. At the 3-month reassessment, most demonstrated mastery of thoracic scans. All required prompting for satisfactory tracheal scans. All felt positively toward POCUS and the remote curriculum.
Pediatric critical care team members acquired and retained knowledge and skills for POCUS basics and ETT placement confirmation through a remote curriculum. Participants were satisfied with the course. Further studies are needed to reassess longer-term knowledge and skill retention and the effects on patient outcomes.
即时护理点超声(POCUS)用于实时管理患者。本研究旨在教授儿科重症监护团队成员使用 POCUS 确认经气管插管(ETT)的位置。次要目的是评估为此目的的远程课程的可行性。
使用 Kern 6 步方法。课程包括虚拟教学、异步学习模块,以及使用 Butterfly IQ+探头、Butterfly Network, Inc、Guilford, CT 的遥测指导进行远程实践课程。参与者学习 ETT 位置确认的直接和间接方法,并被指导进行独立练习。结果包括态度和满意度、知识和技能的获取和保留,以及在轮班时使用 POCUS。
10 名参与者完成了课程。旋钮技能和测验得分分别提高了 29.3%和 20.8%。重新评估时仍保持改善。10 名参与者中有 7 名进行了独立扫描。在 3 个月的重新评估中,大多数人都掌握了胸部扫描。所有的人都需要提示才能获得满意的气管扫描。所有人都对 POCUS 和远程课程持积极态度。
儿科重症监护团队成员通过远程课程获得并保留了 POCUS 基础知识和 ETT 位置确认的知识和技能。参与者对课程感到满意。需要进一步研究来重新评估长期的知识和技能保留以及对患者结果的影响。