Document Detail


Focused abdominal sonogram for trauma: the learning curve of nonradiologist clinicians in detecting hemoperitoneum.
MedLine Citation:
PMID:  10217217     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The focused abdominal sonogram for trauma (FAST) has been used by surgeons and emergency physicians (CLIN) to screen reliably for hemoperitoneum after trauma. Despite recommendations for "appropriate training," ranging from 50 to 400 proctored examinations, there are no supporting data. METHODS: We prospectively examined the initial FAST experience of CLIN in detecting hemoperitoneum by using diagnostic peritoneal lavage, computed tomography, and clinical findings as the diagnostic "gold standard." RESULTS: 241 patients had FAST performed by 12 CLIN (average, 20/CLIN; range, 2-43); 51 patients (21.2%) had hemoperitoneum and 17 patients (7.1%) required laparotomy. Initial experience with FAST by CLIN produced 35 true positives, 180 true negatives, 16 false negatives, and 3 false positives; sensitivity, 68%; specificity, 98%. Initial error rate was 17%, which fell to 5% after 10 examinations (chi2; p < 0.05). CONCLUSION: Previous recommendations for the number of proctored examinations for individual nonradiologist clinician sonographers to develop competence are excessive.
Authors:
S R Shackford; F B Rogers; T M Osler; M E Trabulsy; D W Clauss; D W Vane
Related Documents :
7661477 - Aspiration of free blood from the peritoneal cavity does not mandate immediate laparotomy.
16755457 - Successful surgical treatment of a combined abdominal and thoracic impalement injury.
23227047 - Robotic versus endoscopic thyroidectomy for thyroid cancers: a multi-institutional anal...
25320107 - The role of knotless barbed suture in gynecologic surgery: systematic review and meta-a...
10775907 - Wound complications following vertical banded gastroplasty: report of experience and re...
25435827 - The role of synthetic and biologic materials in the treatment of pelvic organ prolapse.
Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  The Journal of trauma     Volume:  46     ISSN:  0022-5282     ISO Abbreviation:  J Trauma     Publication Date:  1999 Apr 
Date Detail:
Created Date:  1999-05-18     Completed Date:  1999-05-18     Revised Date:  2005-11-16    
Medline Journal Info:
Nlm Unique ID:  0376373     Medline TA:  J Trauma     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  553-62; discussion 562-4     Citation Subset:  AIM; IM    
Affiliation:
University of Vermont, Department of Surgery, Burlington 05401, USA. sshackfo@salus.med.uvm.edu
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Abdominal Injuries / diagnosis,  ultrasonography*
Adult
Diagnostic Errors / statistics & numerical data
Emergency Medicine / education
Female
Hemoperitoneum / ultrasonography*
Humans
Injury Severity Score
Learning
Male
Peritoneal Lavage
Prospective Studies
Radiology / education*
Sensitivity and Specificity
Tomography, X-Ray Computed
Ultrasonography / standards*
Vermont
Wounds, Nonpenetrating / classification,  ultrasonography*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  The role of ultrasound in patients with possible penetrating cardiac wounds: a prospective multicent...
Next Document:  Trauma care regionalization: a process-outcome evaluation.