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埃塞俄比亚亚的斯亚贝巴两家教学转诊医院的高级急诊医学和重症监护住院医师对床旁超声(POCUS)的使用情况及障碍

Point of Care Ultrasound (POCUS) Utilization and Barriers by Senior Emergency Medicine and Critical Care Residents at Two Teaching Referral Hospitals, Addis Ababa, Ethiopia.

作者信息

Tadesse Ayalew Zewdie, Abicho Temesgen Beyene, Alemu Dirijit Mamo, Aspler Anne

机构信息

St Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia.

Addis Ababa University, Addis Ababa, Ethiopia.

出版信息

Emerg Med Int. 2023 Mar 18;2023:7584670. doi: 10.1155/2023/7584670. eCollection 2023.

Abstract

BACKGROUND

POCUS has become an integral part of the practice of emergency medicine. POCUS is a highly focused, limited, goal-directed exam with the expressed purpose of answering selected questions used at the bedside for critically ill patients who are not stable. We aimed to assess POCUS utilization and barriers by senior-year emergency medicine and critical care residents at two tertiary academic and referral hospitals in Addis Ababa, Ethiopia. . A cross-sectional study was conducted from June 1 to August 30, 2022 in St Paul's Hospital Millennium Medical College and Tikur Anbessa Specialized Hospital using an electronic survey of senior-year (second and third years) emergency medicine and critical care residents. Data were collected using Goggle form, exported to SPSS version 24, and then analyzed.

RESULT

Seventy-six residents out of 78 (97.4%) responded to the online survey. The mean age was 29.9 years with an SD of 2.87. Fifty-six residents (73.7%) were male and 45 (59.2%) were year 2 residents. Sixty-one (76.3%) had previous POCUS training. Fifty residents (82.0%) received training from the classroom. Twenty-seven residents (35.5%) rated their current level of knowledge as good for sterile transducer techniques, 28 (36.8%) rated fair for their knobology, and 27 (35.5%) rated very good for their transducer selection knowledge. Thirty-two (42.1%) rated very good about their ability to interpret IVC. 26 (34.2%) responded that they had good ability to interpret FAST/EFAST. Forty-nine (64.5%) residents claimed lack of an ultrasound machine followed by 33 (43.4%) lack of organized curriculum were the main barriers to POCUS utilization. Forty-two (55.3%) residents preferred to complete face-to-face teaching, while 33 (43.4%) preferred blended learning both face-to-face and online.

CONCLUSION

POCUS is performed by the majority of EMCC residents. The most frequent scans performed by residents were FAST, IVC, and lung scans. Lack of ultrasound machine and organized curriculum was the main barrier to US utilization. Availability of equipment, face-to-face training, and having an organized curriculum are recommended by residents to improve their skills in the future.

摘要

背景

床旁超声检查(POCUS)已成为急诊医学实践中不可或缺的一部分。POCUS是一种高度聚焦、有限的、目标导向的检查,其明确目的是回答用于不稳定危重症患者床边检查的特定问题。我们旨在评估埃塞俄比亚亚的斯亚贝巴两家三级学术和转诊医院的急诊医学和重症医学高年级住院医师对POCUS的使用情况及障碍。2022年6月1日至8月30日,在圣保罗医院千禧医学院和提库尔·安贝萨专科医院进行了一项横断面研究,采用电子调查问卷对急诊医学和重症医学高年级(二年级和三年级)住院医师进行调查。数据通过谷歌表单收集,导出至SPSS 24版本,然后进行分析。

结果

78名住院医师中有76名(97.4%)回复了在线调查。平均年龄为29.9岁,标准差为2.87。56名住院医师(73.7%)为男性,45名(59.2%)为二年级住院医师。61名(76.3%)曾接受过POCUS培训。50名住院医师(82.0%)接受过课堂培训。27名住院医师(35.5%)认为他们目前无菌探头技术的知识水平良好,28名(36.8%)认为他们的操作技能水平一般,27名(35.5%)认为他们的探头选择知识水平非常好。32名(42.1%)认为他们解释下腔静脉(IVC)的能力非常好。26名(34.2%)回复称他们有很好的能力解释快速扫查(FAST)/扩展快速扫查(EFAST)。49名(64.5%)住院医师称缺乏超声设备是POCUS使用的主要障碍,其次33名(43.4%)称缺乏系统课程也是主要障碍。42名(55.3%)住院医师更喜欢面对面教学,而33名(43.4%)更喜欢面对面和在线相结合的混合式学习。

结论

大多数急诊医学和重症医学住院医师都进行POCUS检查。住院医师最常进行的扫描是FAST、IVC和肺部扫描。缺乏超声设备和系统课程是超声使用的主要障碍。住院医师建议提供设备、面对面培训并制定系统课程,以提高他们未来的技能。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/13fb/10039804/7c599bfe8ef6/EMI2023-7584670.001.jpg

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