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伦敦空中救护服务机构定制的院前即时超声教学与培训项目的可行性及影响

Feasibility and impact of a bespoke pre-hospital point of care ultrasound teaching and training programme at London's air ambulance service.

作者信息

Naeem Salman, Durrands Thomas, Christian Michael, Nevin Daniel

机构信息

Physician Response Unit, London's Air Ambulance, London, UK.

Royal Free Hospital, London, UK.

出版信息

Ultrasound. 2023 Aug;31(3):230-235. doi: 10.1177/1742271X221139177. Epub 2022 Dec 23.

Abstract

INTRODUCTION

Point-of-care ultrasound has seen an increase in its use in pre-hospital emergency care. There is lack of literature around the training requirement for point-of-care ultrasound of pre-hospital clinicians. This service evaluation assesses the effectiveness of a bespoke hybrid teaching programme.

METHODS

This is a service evaluation of the point-of-care ultrasound teaching programme at London's Air Ambulance from 1 April to 28 May 2021. Subjects' knowledge, image interpretation and confidence were assessed at two different points. Data were gathered using REDCap and exported to Excel for analysis. Mean values and delta were calculated, and -test was applied for statistical significance.

RESULTS

In total, 57 participants were included; out of which 11 were excluded, as they did not complete a post-course survey. Of these, 41.3% participants were point-of-care ultrasound naïve. Mean pre- and post-course scores were 76.5% and 81.7%, respectively, with an average delta improvement of 5.2% (95% confidence interval = 4.70%-5.68%) which was statistically significant ( < 0.002). There was a statistically significant mean improvement of pre- and post-course scores between point-of-care ultrasound naïve and point-of-care ultrasound experienced groups ( = 0.014). Confidence in using point-of-care ultrasound showed mean overall improvement from 2.36/4 to 3.34/4, a mean difference of 0.98 (95% confidence interval = 0.61-1.34), which was statistically significant ( = 0.0039).

CONCLUSION

Our service evaluation highlighted that a hybrid teaching model used by London's Air Ambulance was feasible and had shown significant improvement in the knowledge, image interpretation and confidence of both the point-of-care ultrasound naïve and the PoCUS experienced cohort of clinicians.

摘要

引言

即时超声在院前急救中的应用有所增加。关于院前临床医生即时超声培训要求的文献较少。本服务评估旨在评估定制混合教学计划的有效性。

方法

这是对伦敦空中救护队2021年4月1日至5月28日即时超声教学计划的服务评估。在两个不同时间点评估受试者的知识、图像解读能力和信心。使用REDCap收集数据并导出到Excel进行分析。计算平均值和差值,并应用t检验进行统计学显著性分析。

结果

共纳入57名参与者;其中11名被排除,因为他们未完成课程后调查。这些参与者中,41.3%对即时超声一无所知。课程前和课程后的平均分数分别为76.5%和81.7%,平均差值改善为5.2%(95%置信区间=4.70%-5.68%),具有统计学显著性(P<0.002)。在对即时超声一无所知和有经验的两组之间,课程前和课程后的分数有统计学显著性的平均改善(P=0.014)。使用即时超声的信心显示总体平均从2.36/4提高到3.34/4,平均差异为0.98(95%置信区间=0.61-1.34),具有统计学显著性(P=0.0039)。

结论

我们的服务评估强调,伦敦空中救护队使用的混合教学模式是可行的,并且在对即时超声一无所知和有经验的临床医生群体的知识、图像解读能力和信心方面都有显著提高。

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