Weimer Johannes, Chrissostomou Christopher David, Jonck Christopher, Weimer Andreas Michael, Ille Carlotta, Müller Lukas, Lorenz Liv Annebritt, Stäuber Marie, Vieth Thomas, Buggenhagen Holger, Weinmann-Menke Julia, Rink Maximilian, Künzel Julian
Department of Internal Medicine I, University Medical Center of the Johannes Gutenberg University Mainz, 55131 Mainz, Germany.
Rudolf Frey Learning Clinic, University Medical Center of the Johannes Gutenberg University Mainz, 55131 Mainz, Germany.
Diagnostics (Basel). 2025 May 21;15(10):1296. doi: 10.3390/diagnostics15101296.
: Acute obstructions of the upper respiratory tract are emergencies that may require a cricothyrotomy as ultima ratio. For this, precise identification of the conic ligament is essential. Point-of-care ultrasound (POCUS) offers a reliable tool for anatomical localization in challenging cases and could be used by a range of emergency medicine workers. This prospective, controlled observational study assesses the development of competencies of paramedics (PMs) in point-of-care ultrasound (POCUS) assisted identification of the conic ligament after structured training, and compares their competence level to emergency physicians (EPs). : PMs and a control group of EPs received an identical structured training program as part of an ultrasound course. It included a 10-min theoretical introduction, a 10-min video, and a 45-min practical session with ultrasound devices. Questionnaires and a practical test assessed both group's previous experiences, satisfaction with training, and the development of subjective and objective competencies before (T) and after (T) the training. : A total of 120 participants (N = 92 PMs and N = 28 EPs) participated. A minority had previously performed a cricothyrotomy even in training settings (PMs 17%; EPs 11%), and none had identified the conic ligament using POCUS. The study group's subjective and objective competencies increased significantly ( < 0.001). At T2, the study group demonstrated comparable subjective ( = 0.22) and objective ( = 0.81) competencies to those of the control group. The study group needed significantly ( < 0.01) less time to perform the DOPS. While both groups were satisfied with the study material (PMs 2.2 ± 1.2 vs. Eps 1.6 ± 1.0; = 0.02) and the training (PMs 1.8 ± 1.0 vs. EPs 1.4 ± 0.7, = 0.03), the study group rated both significantly better. : After structured training, paramedics successfully identified the conic ligament using POCUS comparably to emergency physicians. Integrating POCUS into paramedic training may improve prehospital airway management and enhance patient safety. Further studies should investigate long-term skill retention and real-life application.
上呼吸道急性梗阻是可能需要进行环甲膜切开术作为最终手段的紧急情况。为此，精确识别圆锥韧带至关重要。床旁超声（POCUS）为具有挑战性的病例提供了一种可靠的解剖定位工具，并且一系列急诊医学工作者都可以使用。这项前瞻性、对照观察性研究评估了护理人员（PMs）在经过结构化培训后，使用床旁超声（POCUS）辅助识别圆锥韧带的能力发展情况，并将他们的能力水平与急诊医生（EPs）进行比较。：护理人员和一个由急诊医生组成的对照组参加了一个相同的结构化培训项目，作为超声课程的一部分。它包括10分钟的理论介绍、10分钟的视频以及45分钟使用超声设备的实践课程。问卷和实践测试评估了两组在培训前（T₁）和培训后（T₂）的既往经验、对培训的满意度以及主观和客观能力的发展情况。：共有120名参与者（N = 92名护理人员和N = 28名急诊医生）参与。少数人即使在培训环境中也未曾进行过环甲膜切开术（护理人员17%；急诊医生11%），并且没有人使用POCUS识别过圆锥韧带。研究组的主观和客观能力显著提高（P < 0.001）。在T₂时，研究组在主观（P = 0.22）和客观（P = 0.81）能力方面与对照组相当。研究组执行直接观察操作技能（DOPS）所需的时间显著更少（P < 0.01）。虽然两组对学习材料（护理人员2.2 ± 1.2 vs. 急诊医生1.6 ± 1.0；P = 0.02）和培训（护理人员1.8 ± 1.0 vs. 急诊医生1.4 ± 0.7，P = 0.03）都很满意，但研究组对两者的评价明显更好。：经过结构化培训后，护理人员使用POCUS识别圆锥韧带的成功率与急诊医生相当。将POCUS纳入护理人员培训可能会改善院前气道管理并提高患者安全性。进一步的研究应调查长期技能保持情况和实际应用情况。
