Quillen College of Medicine, East Tennessee State University, Johnson, TN, USA.
Division of Surgical Critical Care, Department of Surgery, University of Tennessee Medical Center, Knoxville, TN, USA.
Am Surg. 2024 Jul;90(7):1934-1936. doi: 10.1177/00031348241241747. Epub 2024 Mar 24.
Extended focused assessment with sonography for trauma (eFAST) is a rapid triage tool aiding the detection of life-threatening injuries. In academic settings, residents perform most eFAST; however, the ACGME has no recommendations for eFAST training standards. We surveyed general surgery programs (GSPs) regarding eFAST training and established a baseline for sensitivity, specificity, and positive and negative predictive values for resident-performed eFAST. US GSP eFAST surveys were conducted by email and phone. We prospectively collected patient variables and evaluated resident performance from May to September 2022 and 2023 at an academic level I trauma center. A total of 60/339 general surgery residency programs (GSRPs) responded: Ten use Advanced Trauma Life Support (ATLS) only, n = 7 group training, n = 8 on-the-job only, and n = 33 several methods. Resident-performed eFAST had accuracy = 85.6%, sensitivity = 35.6%, specificity = 97.2%, PPV = 75%, and NPV = 87%. General surgery residency program training in eFAST is non-standardized. Sensitivity was considerably lower than the literature suggests. Positive resident-performed eFAST is generally accurate. We recommend a standardized approach to resident training in eFAST.
扩展重点外伤超声评估（eFAST）是一种快速分诊工具，有助于发现危及生命的损伤。在学术环境中，住院医师进行大多数 eFAST；然而，ACGME 没有关于 eFAST 培训标准的建议。我们调查了普通外科项目（GSP）的 eFAST 培训情况，并为住院医师进行的 eFAST 建立了敏感性、特异性、阳性和阴性预测值的基线。美国 GSP 的 eFAST 调查通过电子邮件和电话进行。我们前瞻性地收集了 2022 年 5 月至 9 月和 2023 年在学术一级创伤中心的患者变量，并评估了住院医师的表现。共有 60/339 普通外科住院医师项目（GSRP）做出了回应：10 个使用高级创伤生命支持（ATLS），n = 7 组培训，n = 8 在职培训，n = 33 多种方法。住院医师进行的 eFAST 具有 85.6%的准确性、35.6%的敏感性、97.2%的特异性、75%的阳性预测值和 87%的阴性预测值。eFAST 普通外科住院医师培训是非标准化的。敏感性明显低于文献建议。阳性的住院医师进行的 eFAST 通常是准确的。我们建议采用标准化方法对住院医师进行 eFAST 培训。
