Goal-directed ultrasound in emergency medicine: evaluation of a specific training program using an ultrasonic stethoscope

Cédric Carrié, Matthieu Biais, Stéphane Lafitte, Nicolas Grenier, Philippe Revel, Gérard Janvier
European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine 2015, 22 (6): 419-25

OBJECTIVE: This observational study aimed to define the learning curve in goal-directed ultrasound (US) after a 2-day training course dedicated to novice emergency residents.

MATERIALS AND METHODS: After completion of the training program, 180 patients requiring goal-directed US examination were examined by a resident and by an experienced investigator. The main endpoints were the diagnostic agreement between the two operators for 14 clinical questions, the duration of the examinations, the number of nonaddressed questions, and the final diagnosis. All criteria were analyzed according to the experience of the resident every 10 examinations.

RESULTS: After 30 supervised examinations, residents adequately assessed with a very good or considerable agreement global left ventricular systolic dysfunction [κ=0.92; 95% confidence interval (CI): 0.80-1], severe right ventricular dilation (κ=0.73; 95% CI: 0.37-1), inferior vena cava diameter (κ=0.88; 95% CI: 0.71-1), and pericardial effusion (κ=0.85; 95% CI: 0.55-1). In general US, 20 supervised examinations were required to diagnose intraperitoneal effusion (κ=0.81; 95% CI: 0.61-1), cholelithiasis (κ=0.73; 95% CI: 0.36-1), obstructive uropathy (κ=0.85; 95% CI: 0.56-1), bladder distention (κ=1; 95% CI: 1-1), abdominal aortic aneurism (κ=0.9; 95% CI: 0.74-1), alveolar interstitial pattern (κ=0.87; 95% CI: 0.74-0.99), consolidated lung (κ=0.83; 95% CI: 0.68-0.97), or pleural effusion (κ=0.89; 95% CI: 0.77-1). After 30 supervised examinations, the overall diagnostic accuracy was judged excellent between the two investigators, with a significant improvement during the learning curve.

CONCLUSION: The performance of 30 supervised and goal-oriented examinations appeared adapted to adequately answer clinical questions covered by core applications of emergency US.

Full Text Links

Find Full Text Links for this Article


You are not logged in. Sign Up or Log In to join the discussion.

Related Papers

Remove bar
Read by QxMD icon Read

Save your favorite articles in one place with a free QxMD account.


Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"