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Emergency ultrasound: a prospective study on sufficient adequate training for military doctors
N Cazes1, F Desmots, Y Geffroy
1Emergency Department, Laveran Army Training Hospital, 34, boulevard Laveran, BP 60149, 13384 Marseille cedex 13, France.
Purpose:
To evaluate the feasibility of "accelerated" training for military doctors in front line ultrasound. To establish the number of ultrasounds required to validate the doctor's training. To assess the average acquisition time for each ultrasound target.
Materials And Methods:
Prospective study on 10 novice generalist military doctors to assess training for five urgent ultrasound targets: focused assessment with sonography in trauma (FAST), pleura, bladder, abdominal aorta and gallbladder. Each student received theoretical and practical training on "healthy" people and then performed 10 timed ultrasounds in an emergency situation, the result of which was either confirmed or rejected by a nationally qualified ultrasound expert.
Results:
Some targets were easier to acquire (bladder, aorta and pleura) with excellent diagnostic performance after 10 ultrasounds on healthy people (sensitivity = 100%; specificity = 100%). The overall number of ultrasound errors fell over time. The median investigation time also fell significantly for all targets, reaching a plateau. Twenty ultrasounds including 10 "real life" appear to be needed for FAST. A minimum number of 30 ultrasounds is required to diagnose acute cholecystitis.
Conclusion:
"Accelerated" training for generalist military doctors in front line ultrasound is achievable. The recommended number of 25 ultrasounds per target is not appropriate for all ultrasound targets.
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