使用剑突下检查(EASy)进行超声心动图评估的一天集中培训是否足够?一家三级医院应对 COVID-19 危机和使用 EASy 检查支持全科图像采集。

Q4 Medicine
Critical care explorations Pub Date : 2024-02-26 eCollection Date: 2024-03-01 DOI:10.1097/CCE.0000000000001038
Nibras F Bughrara, Maegan R Neilson, Stephanie Jones, Lorna Workman, Amit Chopra, Aliaksei Pustavoitau
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引用次数: 0

摘要

目的我们评估了为期 1 天的剑突下超声心动图(EASy)评估培训的效果,随后在查房时对图像解读和决策进行指导,以此作为在重症患者中推广使用护理点超声(POCUS)的新方法:设计:对医疗记录和EASy检查图像进行回顾性分析:背景:三级医疗学术医院:2020年4月6日至17日期间,在奥尔巴尼医疗中心快速反应团队的护理下,共14名患有COVID-19相关呼吸衰竭的成人(18岁以上)接受了至少一次EASy检查:住院医师(之前为超声技师新手)接受为期一天的 EASy 检查培训,包括授课和实践培训,随后由超声心动图认证医师在每日查房时协助进行独立图像采集和监督图像解读、血流动力学模式识别以及临床决策:我们记录了住院医师获得的 EASy 图像的质量、扫描时间以及指导医师需要重复检查或获得额外图像的频率。共进行了 63 次 EASy 检查;平均扫描时间为 4.3 分钟。其中 55 次(87%)住院医师获得的图像足以用于临床决策,其余 8 次(13%)主管医师获得了更多图像:结论:在资源稀缺的条件下,EASy 检查是一种高效、有价值的工具。为期 1 天的培训后,在指导下进行图像解读和决策的教育模式可迅速扩大超声技师队伍,并将床旁超声心动图纳入重症监护病房的常规患者管理中。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Is 1 Day of Focused Training in Echocardiographic Assessment Using Subxiphoid-Only (EASy) Examination Enough? A Tertiary Hospital Response to the COVID-19 Crisis and the Use of the EASy Examination to Support Unit-Wide Image Acquisition.

Objectives: We assessed the efficacy of 1-day training in echocardiography assessment using subxiphoid-only (EASy) followed by supervised image interpretation and decision-making during patient rounds as a novel approach to scaling up the use of point-of-care ultrasound (POCUS) in critically ill patients.

Design: Retrospective analysis of medical records and EASy examination images.

Setting: Tertiary care academic hospital.

Patients: A total of 14 adults (> 18 yr old) with COVID-19-associated respiratory failure under the care of Albany Medical Center's surge response team from April 6-17, 2020 who received at least one EASy examination.

Interventions: Residents (previously novice sonographers) were trained in EASy examination using 1 day of didactic and hands-on training, followed by independent image acquisition and supervised image interpretation, identification of hemodynamic patterns, and clinical decision-making facilitated by an echocardiography-certified physician during daily rounds.

Measurements and main results: We recorded the quality of resident-obtained EASy images, scanning time, and frequency with which the supervising physician had to repeat the examination or obtain additional images. A total of 63 EASy examinations were performed; average scanning time was 4.3 minutes. Resident-obtained images were sufficient for clinical decision-making on 55 occasions (87%), in the remaining 8 (13%) the supervising physician obtained further images.

Conclusions: EASy examination is an efficient, valuable tool under conditions of scarce resources. The educational model of 1-day training followed by supervised image interpretation and decision-making allows rapid expansion of the pool of sonographers and implementation of bedside echocardiography into routine ICU patient management.

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CiteScore
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