Document Detail


Pilot study to determine the feasibility of training Army National Guard medics to perform focused cardiac ultrasonography.
MedLine Citation:
PMID:  19947876     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To assess the ability of Army National Guard combat medics to perform a limited bedside echocardiography (BE) to determine cardiac activity after a brief training module. METHODS: Twelve Army National Guard health care specialists trained to the level of emergency medical technician-basic (EMT-B) underwent an educational session consisting of a 5-minute lecture on BE followed by hands-on practical training. After the training session, each medic performed BEs, in either the subxiphoid (SX) or parasternal (PS) location at his or her discretion, on four healthy volunteers. The time required to complete the BE and the anatomic location of the examination (SX vs. PS) was documented. A 3-second video clip representing the best image was recorded for each BE. These clips were subsequently reviewed independently by two of the investigators with experience performing and interpreting BE; each BE was graded on a six-point scale designed for the study, the Cardiac Ultrasound Structural Assessment Scale (CUSAS). A score of 3 or greater was considered to be adequate to assess for the presence of cardiac activity. Where there was disagreement on the CUSAS score, the reviewers viewed the clip together and agreed on a consensus CUSAS score. We calculated the median time to completion and interquartile range (IQR) for each BE, the median CUSAS scores and IQR for examinations performed in the SX and PS locations, and kappa for agreement between the two reviewers on the CUSAS. RESULTS: A total of 48 BEs were recorded and reviewed. Thirty-seven of 48 (77%) were obtained in the SX location, and 11 of 48 (23%) were obtained in the PS location. Forty-four of 48 (92%) were scored as a 3 or higher on the CUSAS. Median time to completion of a BE was 5.5 seconds (IQR: 3.7-10.9 seconds). The median CUSAS score in the SX location was 4 (IQR: 4-5), and the median CUSAS score in the PS location was 4 (IQR: 4-4). Weighted kappa for the CUSAS was 0.6. CONCLUSION: With minimal training, the vast majority of the medics in our study were able to rapidly perform a focused BE on live models that was adequate to assess for the presence of cardiac activity.
Authors:
Brandon H Backlund; Carl J Bonnett; Jeffrey P Faragher; Jason S Haukoos; John L Kendall
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Prehospital emergency care : official journal of the National Association of EMS Physicians and the National Association of State EMS Directors     Volume:  14     ISSN:  1545-0066     ISO Abbreviation:  Prehosp Emerg Care     Publication Date:    2010 Jan-Mar
Date Detail:
Created Date:  2009-12-01     Completed Date:  2010-03-25     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9703530     Medline TA:  Prehosp Emerg Care     Country:  England    
Other Details:
Languages:  eng     Pagination:  118-23     Citation Subset:  IM    
Affiliation:
Department of Emergency Medicine, Denver Health Medical Center, Denver, Colorado 80204, USA. brandon.backlund@dhha.org
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MeSH Terms
Descriptor/Qualifier:
Clinical Competence / standards*
Echocardiography*
Feasibility Studies
Humans
Military Personnel / education*
Pilot Projects
Task Performance and Analysis
Teaching / methods
United States

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


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