Garofalo Eugenio, Neri Giuseppe, Bosco Vincenzo, Zaninni Caroleo, Virdò Fabiola, Mastrangelo Helenia, Guzzi Giusy, Cammarota Gianmaria, Robba Chiara, Longhini Federico, Bruni Andrea
Anesthesia and Intensive Care, Department of Medical and Surgical Sciences, "Magna Graecia" University, Catanzaro, Italy.
Department of Neurosurgery, "R Dulbecco" University Hospital, Catanzaro, Italy.
Ultrasound J. 2025 Jun 16;17(1):28. doi: 10.1186/s13089-025-00431-7.
The measurement of the optic nerve sheath diameter (ONSD) via ultrasound is a non-invasive technique to estimate intracranial pressure. Brief training has been shown to be effective in accurately teaching the ONSD technique in specialized healthcare providers. This study evaluates the ability of medical and nursing students, Intensive Care Unit (ICU) nurses, and ICU residents to perform ONSD measurements after a brief training.
Forty participants underwent a 4-h training session consisting of 30 min of lecture focusing on the key principles of the technique for ONSD measurement, followed by at least 20 measurements with an expert tutor. Thereafter, all participants assessed 5 ONSD measurements on healthy volunteers and their assessments were compared to those by the expert tutor.
All participants successfully visualized the optic nerve and recorded similar values among groups (p > 0.05 for all comparisons). ICU nurse residents and medical students demonstrated a good accuracyof measurements, as defined by an upper and lower limits of agreement with the expert tutor not exceeding 0.5 mm in the Bland-Altman analysis. On the opposite, nurse students had the highest error rates and poor accuracy in ONSD assessment.
These findings highlight the feasibility of training medical students, ICU nurses and residents in ONSD measurement, opening the possibility of a wider application of this technique. After dedicated training, ONSD assessment and monitoring could be performed not only by specialists but also by other healthcare providers, including specialized nurses. This may serve as an additional tool for the rapid triage of patients, even in out-of-hospital settings.
通过超声测量视神经鞘直径（ONSD）是一种估计颅内压的非侵入性技术。研究表明，简短培训能有效教会专业医护人员准确掌握ONSD测量技术。本研究评估了医学生、护生、重症监护病房（ICU）护士和ICU住院医师在接受简短培训后进行ONSD测量的能力。
40名参与者参加了为期4小时的培训课程，其中包括30分钟关于ONSD测量技术关键原理的讲座，随后在专家导师指导下至少进行20次测量。此后，所有参与者对健康志愿者进行5次ONSD测量，并将他们的评估结果与专家导师的评估结果进行比较。
所有参与者均成功可视化视神经，且各组记录的值相似（所有比较的p>0.05）。在Bland-Altman分析中，ICU护士住院医师和医学生测量的准确度良好，即与专家导师的一致性上下限不超过0.5毫米。相反，护生在ONSD评估中的错误率最高，准确度较差。
这些发现突出了培训医学生、ICU护士和住院医师进行ONSD测量的可行性，为该技术更广泛的应用开辟了可能性。经过专门培训后，不仅专科医生，其他医护人员，包括专科护士也可以进行ONSD评估和监测。这甚至在院外环境中也可作为快速分诊患者的额外工具。
