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Todsen T, Ewertsen C, Jenssen C, Evans R, Kuenzel J. Head and Neck Ultrasound - EFSUMB Training Recommendations for the Practice of Medical Ultrasound in Europe. Ultrasound Int Open 2022; 8:E29-E34. [PMID: 36212171 PMCID: PMC9546639 DOI: 10.1055/a-1922-6778] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Accepted: 07/27/2022] [Indexed: 11/07/2022] Open
Abstract
Different surgical and medical specialists increasingly use head and neck
ultrasound and ultrasound-guided interventions as part of their clinical
practice. We need to ensure high quality and standardized practice across
specialties, and this position paper of the European Federation of Societies for
Ultrasound in Medicine and Biology (EFSUMB) describes the training requirements
for head and neck ultrasound. Traditionally, a minimum number of ultrasound
examinations indicates competence, but this is unreliable, and a general shift
towards competence-based training is ongoing. For each EFSUMB level, we will
outline the theoretical knowledge and skills needed for clinical practice. The
recommendations follow the three EFSUMB competency levels for medical ultrasound
practice. Level 1 describes the skills required to perform essential head and
neck ultrasound examinations independently, level 2 includes ultrasound-guided
interventions, while level 3 involves the practice of high-level neck ultrasound
and use of advanced technologies. Our goal is to ensure high quality and
standardized head and neck ultrasound practice performed by different clinical
specialists with these recommendations.
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Affiliation(s)
- Tobias Todsen
- Department of Otorhinolaryngology, Head and Neck Surgery and Audiology,
Rigshospitalet, Denmark,Copenhagen Academy for Medical Education and Simulation, University of
Copenhagen, and The Capital Region of Denmark, Copenhagen, Denmark,Department of Clinical Medicine, University of Copenhagen,
Denmark
| | - Caroline Ewertsen
- Department of Clinical Medicine, University of Copenhagen,
Denmark,Department of Radiology, Copenhagen University Hospital,
Rigshospitalet, Copenhagen, Denmark
| | - Christian Jenssen
- Department of Internal Medicine, Krankenhaus Märkisch Oderland
GmbH, Strausberg, Germany,Brandenburg Institute for Clinical Ultrasound, Medical University
Brandenburg, Neuruppin, Germany
| | - Rhodri Evans
- Department of Radiology, Withybush General Hospital, Swansea, United
Kingdom of Great Britain and Northern Ireland
| | - Julian Kuenzel
- Department of Otorhinolaryngology, Head and Neck Surgery, University
Hospital Regensburg, Regensburg, Germany
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2
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Rosenfeldt Nielsen M, Kristensen EQ, Jensen RO, Mollerup AM, Pfeiffer T, Graumann O. Clinical Ultrasound Education for Medical Students: Virtual Reality Versus e-Learning, a Randomized Controlled Pilot Trial. Ultrasound Q 2021; 37:292-296. [PMID: 34478430 DOI: 10.1097/ruq.0000000000000558] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
ABSTRACT The primary aim was to evaluate the effect of immersive virtual reality learning for training medical students in basic clinical ultrasound. Secondary outcomes were to explore if virtual reality learning had an effect on hand-eye coordination skills and if the medical students wanted more virtual reality learning.This pilot study was a double-blind, parallel-group, block-randomized, controlled trial. Participants (n = 20) were blinded and randomized to virtual reality or e-learning for basic ultrasound education. Medical students with no previous ultrasound education were recruited voluntarily from the University of Southern Denmark. Data were collected during introductory courses on ultrasound from March to May 2019. Participants were assessed with Objective Structured Assessment on Ultrasound Skills. Assessing supervisors were blinded.The virtual reality group (n = 11) scored a significantly higher Objective Structured Assessment on Ultrasound Skills score (143 [95% confidence interval {CI}, 135 to 151]) compared with the e-learning group (n = 9; 126 [95% CI, 113 to 138]; mean difference, 17 points [95% CI, 4 to 30]; P < 0.01). No significant effect on the hand-eye score was found (mean difference, 3 points [95 % CI, -3 to 9]; P = 0.32). Ninety-one percent of the virtual reality group wanted more virtual reality learning.Immersive virtual reality learning improved medical students' ultrasound skills significantly compared with e-learning. The hand-eye score was higher in the virtual reality group, although not at a significant level. Students wanted more virtual reality learning. Further research is needed to clarify immersive virtual reality's educational role in the future.
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Affiliation(s)
| | | | | | | | | | - Ole Graumann
- Radiology Department, Odense University Hospital, Odense, Denmark
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Hartmann TJ, Friebe-Hoffmann U, de Gregorio N, de Gregorio A, Lato C, Hüner B, Friedel T, Janni W, Lato K. Novel and flexible ultrasound simulation with smartphones and tablets in fetal echocardiography. Arch Gynecol Obstet 2021; 305:19-29. [PMID: 34086086 PMCID: PMC8175929 DOI: 10.1007/s00404-021-06102-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Accepted: 05/21/2021] [Indexed: 10/31/2022]
Abstract
PURPOSE Evaluation of a novel ultrasound-simulation-app for training fetal echocardiography as a possible useful addition for students, residents and specialist doctors. Furthermore, comparison to a conventional learning-method with special attention on orientation and recognition of physiological structures. METHODS Prospective two-arm study with the participation of 226 clinical students. 108 students were given an extract from a textbook on fetal echocardiography (PDF-group, n = 108) for 30 min to study. 118 students were able to use the new ultrasound-simulator-app (Simulator-group, n = 118) to learn for 30 min. The knowledge of the students was examined both before and after the learning-period by having them identify sonographic structures in videos using single-choice selection. RESULTS There were no significant differences between the two groups regarding age (p = 0.87), gender (p = 0.28), and the number of previously performed ultrasound-examinations (p = 0.45). In the Simulator-group, there was a significantly higher learning effect regarding the proportion of students with an increase of correct answers in the video test examination (p = 0.005). At the end of learning, the students in the Simulator-group needed significantly less time to display the structures in the app's simulation (median initially 10.9 s vs. 6.8 s at the end; p < 0.001). CONCLUSIONS The novel ultrasound-simulation-app seems to be a useful addition and improvement to ultrasound training. Previous difficulties such as simultaneously having patients, ultrasound-machines, and professors at disposal can thus be avoided. This means that another important step towards remote learning can be taken, which has been proven increasingly essential lately, due to the COVID-19 pandemic.
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Affiliation(s)
- Tim Johannes Hartmann
- Department of Obstetrics and Gynaecology, University Hospital Ulm, Prittwitzstraße 43, 89075, Ulm, Germany.
| | - Ulrike Friebe-Hoffmann
- Department of Obstetrics and Gynaecology, University Hospital Ulm, Prittwitzstraße 43, 89075, Ulm, Germany
| | - Nikolaus de Gregorio
- Department of Obstetrics and Gynaecology, University Hospital Ulm, Prittwitzstraße 43, 89075, Ulm, Germany
| | - Amelie de Gregorio
- Department of Obstetrics and Gynaecology, University Hospital Ulm, Prittwitzstraße 43, 89075, Ulm, Germany
| | - Christiane Lato
- Department of Obstetrics and Gynaecology, University Hospital Ulm, Prittwitzstraße 43, 89075, Ulm, Germany
| | - Beate Hüner
- Department of Obstetrics and Gynaecology, University Hospital Ulm, Prittwitzstraße 43, 89075, Ulm, Germany
| | - Thomas Friedel
- Department of Obstetrics and Gynaecology, University Hospital Ulm, Prittwitzstraße 43, 89075, Ulm, Germany
| | - Wolfgang Janni
- Department of Obstetrics and Gynaecology, University Hospital Ulm, Prittwitzstraße 43, 89075, Ulm, Germany
| | - Krisztian Lato
- Department of Obstetrics and Gynaecology, University Hospital Ulm, Prittwitzstraße 43, 89075, Ulm, Germany
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Riishede M, Lassen AT, Baatrup G, Pietersen PI, Jacobsen N, Jeschke KN, Laursen CB. Point-of-care ultrasound of the heart and lungs in patients with respiratory failure: a pragmatic randomized controlled multicenter trial. Scand J Trauma Resusc Emerg Med 2021; 29:60. [PMID: 33902667 PMCID: PMC8073910 DOI: 10.1186/s13049-021-00872-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2020] [Accepted: 04/01/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Point-of-care ultrasound is a focus oriented tool for differentiating among cardiopulmonary diseases. Its value in the hands of emergency physicians, with various ultrasound experience, remains uncertain. We tested the hypothesis that, in emergency department patients with signs of respiratory failure, a point-of-care cardiopulmonary ultrasound along with standard clinical examination, performed by emergency physicians with various ultrasound experience would increase the proportion of patients with presumptive diagnoses in agreement with final diagnoses at four hours after admission compared to standard clinical examination alone. METHODS In this prospective multicenter superiority trial in Danish emergency departments we randomly assigned patients presenting with acute signs of respiratory failure to intervention or control in a 1:1 ratio by block randomization. Patients received point-of-care cardiopulmonary ultrasound examination within four hours from admission. Ultrasound results were unblinded for the treating emergency physician in the intervention group. Final diagnoses and treatment were determined by blinded review of the medical record after the patients´ discharge. RESULTS From October 9, 2015 to April 5, 2017, we randomized 218 patients and included 211 in the final analyses. At four hours we found; no change in the proportion of patients with presumptive diagnoses in agreement with final diagnoses; intervention 79·25% (95% CI 70·3-86·0), control 77·1% (95% CI 68·0-84·3), an increased proportion of appropriate treatment prescribed; intervention 79·3% (95% CI 70·3-86·0), control 65·7% (95% CI 56·0-74·3) and of patients who spent less than 1 day in hospital; intervention n = 42 (39·6%, 25·8 38·4), control n = 25 (23·8%, 16·5-33·0). No adverse events were reported. CONCLUSIONS Focused cardiopulmonary ultrasound added to standard clinical examination in patients with signs of respiratory failure had no impact on the diagnostic accuracy, but significantly increased the proportion of appropriate treatment prescribed and the proportion of patients who spent less than 1 day in hospital. TRIAL REGISTRATION https://clinicaltrials.gov/ , number NCT02550184 .
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Affiliation(s)
- M Riishede
- Department of Surgery, Odense University Hospital, 5700, Svendborg, Denmark. .,Department of Clinical Research, University of Southern Denmark, SDU-Odense, 5000, Odense, Denmark. .,Department of Internal Medicine & Emergency Medicine (M/FAM), Odense University Hospital, Valdemarsgade 53, 5700, Svendborg, Denmark. .,OPEN, Open Patient data Explorative Network, Odense University Hospital, 5000, Odense, Denmark.
| | - A T Lassen
- Department of Clinical Research, University of Southern Denmark, SDU-Odense, 5000, Odense, Denmark.,Department of Emergency Medicine, Odense University Hospital, 5000, Odense, Denmark
| | - G Baatrup
- Department of Surgery, Odense University Hospital, 5700, Svendborg, Denmark.,Department of Clinical Research, University of Southern Denmark, SDU-Odense, 5000, Odense, Denmark
| | - P I Pietersen
- Department of Clinical Research, University of Southern Denmark, SDU-Odense, 5000, Odense, Denmark.,Department of Respiratory Medicine, Odense University Hospital, 5000, Odense, Denmark.,Regional Center for Technical Simulation (TechSim), Odense University Hospital, 5000, Odense, Denmark
| | - N Jacobsen
- Department of Clinical Research, University of Southern Denmark, SDU-Odense, 5000, Odense, Denmark.,Department of Respiratory Medicine, Odense University Hospital, 5000, Odense, Denmark.,Regional Center for Technical Simulation (TechSim), Odense University Hospital, 5000, Odense, Denmark
| | - K N Jeschke
- Department of Respiratory Medicine, Copenhagen University Hospital, 2650, Hvidovre, Denmark
| | - C B Laursen
- Department of Clinical Research, University of Southern Denmark, SDU-Odense, 5000, Odense, Denmark.,Department of Respiratory Medicine, Odense University Hospital, 5000, Odense, Denmark
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Shin H, Lee I, Kim C, Choi HJ. Point-of-care blood analysis of hypotensive patients in the emergency department. Am J Emerg Med 2019; 38:1049-1057. [PMID: 31492566 DOI: 10.1016/j.ajem.2019.158363] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2019] [Revised: 07/15/2019] [Accepted: 07/21/2019] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE The aim of this study is to compare a point-of-care (POC) analysis, Enterprise POC (epoc), using the capillary blood obtained from skin puncture with conventional laboratory tests using arterial and venous blood in hypotensive patients. METHODS This study was conducted at the emergency department of a tertiary care hospital between June and November 2018. 231 hypotensive patients were enrolled. Three types of blood samples (capillary blood from skin puncture and arterial and venous blood from blood vessel puncture) were collected and analyzed. We compared a total of 13 parameters (pH, pCO2, pO2, HCO3-, Ca2+, lactate, Na+, K+, Cl-, glucose, Hb, Hct, and creatinine) between the POC analysis and reference analyzers by performing the equivalence test and Bland-Altman plot analysis. RESULTS In hypotensive patients, with the exception of two parameters (pCO2, pO2), the pH, HCO3-, Ca2+, lactate, Na+, K+, Cl-, glucose, Hb, Hct, and creatinine parameters measured by the POC analysis were equivalent to or correlated with the reference values. In the patients with cardiac arrest group, nine parameters (pH, HCO3-, Ca2+, Na+, K+, glucose, Hb, Hct, and creatinine) analyzed by the epoc system were equivalent to the reference values. CONCLUSION Most parameters, except pO2, measured by the epoc system using the capillary blood in hypotensive patients were equivalent to or correlated with those measured by the reference analyzers.
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Affiliation(s)
- Hyungoo Shin
- Department of Emergency Medicine, College of Medicine, Hanyang University Guri Hospital, Guri, Republic of Korea
| | - Inhye Lee
- Department of Emergency Medicine, College of Medicine, Hanyang University Guri Hospital, Guri, Republic of Korea
| | - Changsun Kim
- Department of Emergency Medicine, College of Medicine, Hanyang University Guri Hospital, Guri, Republic of Korea.
| | - Hyuk Joong Choi
- Department of Emergency Medicine, College of Medicine, Hanyang University Guri Hospital, Guri, Republic of Korea
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Zwisler ST, Zincuk Y, Bering CB, Zincuk A, Nybo M, Mikkelsen S. Diagnostic value of prehospital arterial blood gas measurements - a randomised controlled trial. Scand J Trauma Resusc Emerg Med 2019; 27:32. [PMID: 30885262 PMCID: PMC6421666 DOI: 10.1186/s13049-019-0612-8] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2018] [Accepted: 03/11/2019] [Indexed: 12/01/2022] Open
Abstract
Background Arterial blood gas analysis is an important diagnostic tool in managing critically ill patients within the hospital. Whether prehospital application of this diagnostic modality contributes to more exact diagnoses and treatments in critically ill prehospital patients is unknown. The aim of this study was to establish whether access to arterial blood gas analysis increased the prehospital diagnostic accuracy of prehospital anaesthesiologists. Furthermore, we investigated whether prehospital blood gas analysis resulted in therapeutic interventions that would not have been carried out if the arterial blood gas analyser had not been available. Methods In a prospective randomised study, two groups of prehospital adult patients with acute critical illness were compared. All patients received standard prehospital care. In the intervention group, an arterial blood gas sample was analysed prehospitally. The primary outcome was the impact of blood gas analysis on the accuracy of prehospital diagnoses. Furthermore, we registered any therapeutic interventions that were carried out as a direct result of the blood gas analysis. Results A total of 310 patients were included in the study. Eighty-eight of these patients were subsequently excluded, primarily due to difficulties in obtaining post hoc consent or venous sampling or other technical difficulties. A total of 102 patients was analysed in the arterial blood gas group (ABG group), while 120 patients were analysed in the standard care group (noABG group). In 78 of the 102 patients in the ABG group, the prehospital physician reported that ABG analysis increased their perceived diagnostic precision. In 81 cases in the noABG group, the lack of arterial blood gas analysis was perceived to have decreased diagnostic accuracy. The claim that ABG analysis increased diagnostic accuracy could, however, not be substantiated as there was no difference in the number of un-specific diagnoses between the groups. Blood gas analysis increased the probability of targeting specific prehospital therapeutic interventions and led to 159 interventions, including intubation, ventilation and/or upgrading the level of urgency, in 71 ABG-group patients (p < 0.001). Conclusion Although prehospital arterial blood gas analysis did not improve the accuracy of the prehospital diagnoses assigned to patients, it significantly increased the quality of treatment provided to patients with acute critical illness. Trial registration ClinicalTrials.gov, NCT03006692, retrospectively registered six months after first patient entry.
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Affiliation(s)
- Stine T Zwisler
- The Mobile Emergency Care Unit, Department of Anaesthesiology and Intensive Care, Odense University Hospital, J.B. Winsløws Vej 4, DK-5000, Odense, C, Denmark.,Department of Anaesthesiology and Intensive Care, Odense University Hospital, DK-5000, Odense, C, Denmark
| | - Yecatarina Zincuk
- The Mobile Emergency Care Unit, Department of Anaesthesiology and Intensive Care, Odense University Hospital, J.B. Winsløws Vej 4, DK-5000, Odense, C, Denmark
| | - Caroline B Bering
- Department of Anaesthesiology and Intensive Care, Odense University Hospital, DK-5000, Odense, C, Denmark
| | - Aleksander Zincuk
- The Mobile Emergency Care Unit, Department of Anaesthesiology and Intensive Care, Odense University Hospital, J.B. Winsløws Vej 4, DK-5000, Odense, C, Denmark.,Department of Anaesthesiology and Intensive Care, Odense University Hospital, DK-5000, Odense, C, Denmark
| | - Mads Nybo
- Department of Clinical Biochemistry and Pharmacology, Odense University Hospital, DK-5000, Odense, C, Denmark
| | - Søren Mikkelsen
- The Mobile Emergency Care Unit, Department of Anaesthesiology and Intensive Care, Odense University Hospital, J.B. Winsløws Vej 4, DK-5000, Odense, C, Denmark. .,Department of Anaesthesiology and Intensive Care, Odense University Hospital, DK-5000, Odense, C, Denmark. .,Institute of Regional Health Research, University of Southern Denmark, DK-5000, Odense C, Denmark.
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7
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Kim C, Kim H. Emergency medical technician-performed point-of-care blood analysis using the capillary blood obtained from skin puncture. Am J Emerg Med 2017. [PMID: 29519760 DOI: 10.1016/j.ajem.2017.12.025] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
OBJECTIVE Comparing a point-of-care (POC) test using the capillary blood obtained from skin puncture with conventional laboratory tests. METHODS In this study, which was conducted at the emergency department of a tertiary care hospital in April-July 2017, 232 patients were enrolled, and three types of blood samples (capillary blood from skin puncture, arterial and venous blood from blood vessel puncture) were simultaneously collected. Each blood sample was analyzed using a POC analyzer (epoc® system, USA), an arterial blood gas analyzer (pHOx®Ultra, Nova biomedical, USA) and venous blood analyzers (AU5800, DxH2401, Beckman Coulter, USA). Twelve parameters were compared between the epoc and reference analyzers, with an equivalence test, Bland-Altman plot analysis and linear regression employed to show the agreement or correlation between the two methods. RESULTS The pH, HCO3, Ca2+, Na+, K+, Cl-, glucose, Hb and Hct measured by the epoc were equivalent to the reference values (95% confidence interval of mean difference within the range of the agreement target) with clinically inconsequential mean differences and narrow limits of agreement. All of them, except pH, had clinically acceptable agreements between the two methods (results within target value ≥80%). Of the remaining three parameters (pCO2, pO2 and lactate), the epoc pCO2 and lactate values were highly correlated with the reference device values, whereas pO2 was not. (pCO2: R2=0.824, y=-1.411+0.877·x; lactate: R2=0.902, y=-0.544+0.966·x; pO2: R2=0.037, y=61.6+0.431·x). CONCLUSION Most parameters, except only pO2, measured by the epoc were equivalent to or correlated with those from the reference method.
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Affiliation(s)
- Changsun Kim
- Department of Emergency Medicine, Hanyang University College of Medicine, Seoul, Republic of Korea.
| | - Hansol Kim
- Department of Emergency Medicine, Hanyang University College of Medicine, Seoul, Republic of Korea
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Riishede M, Laursen CB, Teglbjærg LS, Lassen AT, Baatrup G. Focused ultrasound examination of the chest on patients admitted with acute signs of respiratory problems: a study protocol for a pragmatic randomised controlled multicentre trial. BMJ Open 2016; 6:e012367. [PMID: 27742624 PMCID: PMC5073536 DOI: 10.1136/bmjopen-2016-012367] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
INTRODUCTION Patients with acute respiratory problems poses a diagnostic challenge because similar symptoms can be caused by various pathological conditions. Focused ultrasound examination (f-US) of the heart and lungs has proven to increase the diagnostic accuracy in these patients. In this protocol of a randomised multicentre trial, we study the effect of f-US of the heart and lungs in patients with respiratory problems performed by emergency physicians (EP) as soon as the patient arrives to the emergency department (ED). The primary outcome is the number of patients with a correct presumptive diagnosis at 4 hours from admission. METHODS AND ANALYSIS This is a semiblinded randomised prospective study. 288 patients will be included and randomised into the control or intervention group. All patients receive a standard diagnostic evaluation by the EP to assess the primary presumptive diagnosis. Investigators are EP, with varying degrees of experience in f-US, who perform an f-US of the heart and lungs in patients in both treatment arms. f-US results in the intervention group are non-blinded to the treating EP to be included in the assessment of the 4-hour presumptive diagnosis. As standard for correct diagnosis, we perform a blinded journal audit after discharge. As primary analysis, we use the intention-to-treat analysis. CONCLUSIONS This study is the first multicentre trial in EDs to investigate whether f-US, in the hands of the EP, increases the proportion of correct diagnosis at 4 hours after arrival when performed on patients with respiratory problems. ETHICS AND DISSEMINATION This trial is conducted in accordance with the Helsinki II Declaration and approved by the Danish Data Protection Agency and the Committee on Biomedical Research Ethics for the Region of Southern Denmark. Results will be published in accordance with the CONSORT statement in a peer-reviewed scientific journal regardless of the outcome. TRIAL REGISTRATION NUMBER NCT02550184; Pre-results.
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Affiliation(s)
- M Riishede
- Department of Surgery (A), Odense University Hospital, Svendborg, Denmark Institute of Clinical Research, University of Southern Denmark, SDU-Odense, Denmark Department of Internal Medicine & Emergency Medicine (M/FAM), Odense University Hospital, Svendborg, Denmark
| | - C B Laursen
- Institute of Clinical Research, University of Southern Denmark, SDU-Odense, Denmark Department of Respiratory Medicine, Odense University Hospital, Odense, Denmark
| | - L S Teglbjærg
- Department of Internal Medicine & Emergency Medicine (M/FAM), Odense University Hospital, Svendborg, Denmark
| | - A T Lassen
- Institute of Clinical Research, University of Southern Denmark, SDU-Odense, Denmark Department of Emergency Medicine, Odense University Hospital, Odense, Denmark
| | - G Baatrup
- Department of Surgery (A), Odense University Hospital, Svendborg, Denmark Institute of Clinical Research, University of Southern Denmark, SDU-Odense, Denmark
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Borgersen NJ, Henriksen MJV, Konge L, Sørensen TL, Thomsen ASS, Subhi Y. Direct ophthalmoscopy on YouTube: analysis of instructional YouTube videos' content and approach to visualization. Clin Ophthalmol 2016; 10:1535-41. [PMID: 27574393 PMCID: PMC4993418 DOI: 10.2147/opth.s111648] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Background Direct ophthalmoscopy is well-suited for video-based instruction, particularly if the videos enable the student to see what the examiner sees when performing direct ophthalmoscopy. We evaluated the pedagogical effectiveness of instructional YouTube videos on direct ophthalmoscopy by evaluating their content and approach to visualization. Methods In order to synthesize main themes and points for direct ophthalmoscopy, we formed a broad panel consisting of a medical student, junior and senior physicians, and took into consideration book chapters targeting medical students and physicians in general. We then systematically searched YouTube. Two authors reviewed eligible videos to assess eligibility and extract data on video statistics, content, and approach to visualization. Correlations between video statistics and contents were investigated using two-tailed Spearman’s correlation. Results We screened 7,640 videos, of which 27 were found eligible for this study. Overall, a median of 12 out of 18 points (interquartile range: 8–14 key points) were covered; no videos covered all of the 18 points assessed. We found the most difficulties in the approach to visualization of how to approach the patient and how to examine the fundus. Time spent on fundus examination correlated with the number of views per week (Spearman’s ρ=0.53; P=0.029). Conclusion Videos may help overcome the pedagogical issues in teaching direct ophthalmoscopy; however, the few available videos on YouTube fail to address this particular issue adequately. There is a need for high-quality videos that include relevant points, provide realistic visualization of the examiner’s view, and give particular emphasis on fundus examination.
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Affiliation(s)
- Nanna Jo Borgersen
- Department of Ophthalmology, Zealand University Hospital, Roskilde; Copenhagen Academy for Medical Education and Simulation, the Capital Region of Denmark; Faculty of Health and Medical Sciences, University of Copenhagen
| | - Mikael Johannes Vuokko Henriksen
- Copenhagen Academy for Medical Education and Simulation, the Capital Region of Denmark; Faculty of Health and Medical Sciences, University of Copenhagen
| | - Lars Konge
- Copenhagen Academy for Medical Education and Simulation, the Capital Region of Denmark; Faculty of Health and Medical Sciences, University of Copenhagen
| | - Torben Lykke Sørensen
- Department of Ophthalmology, Zealand University Hospital, Roskilde; Faculty of Health and Medical Sciences, University of Copenhagen
| | - Ann Sofia Skou Thomsen
- Copenhagen Academy for Medical Education and Simulation, the Capital Region of Denmark; Faculty of Health and Medical Sciences, University of Copenhagen; Department of Ophthalmology, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Yousif Subhi
- Department of Ophthalmology, Zealand University Hospital, Roskilde; Faculty of Health and Medical Sciences, University of Copenhagen
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Mikkelsen S, Wolsing-Hansen J, Nybo M, Maegaard CU, Jepsen S. Implementation of the ABL-90 blood gas analyzer in a ground-based mobile emergency care unit. Scand J Trauma Resusc Emerg Med 2015. [PMID: 26224063 PMCID: PMC4520278 DOI: 10.1186/s13049-015-0134-y] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
Point-of Care analysis is increasingly being applied in the prehospital scene. Arterial blood gas analysis is one of many new initiatives adding to the diagnostic tools of the prehospital physician. In this paper we present a study on the feasibility of the Radiometer ABL-90 in a ground-based Mobile Emergency Care Unit and report on some clinical situations in which the apparatus has proven beneficial.
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Affiliation(s)
- Søren Mikkelsen
- Department of Anaesthesiology and Intensive Care Medicine, Mobile Emergency Care Unit, Odense University Hospital, Odense, Denmark.
| | | | - Mads Nybo
- Department of Clinical Biochemistry and Pharmacology, Odense University Hospital, Odense, Denmark
| | | | - Søren Jepsen
- Department of Anaesthesiology and Intensive Care Medicine, Mobile Emergency Care Unit, Odense University Hospital, Odense, Denmark
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