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Sep 13, 2018

ERC congress - Resuscitation 2018

5 - Scan first, ask questions later - the evolution of ultrasound as an adjunct to clinical history taking and examination in acutely and critically ill patients.

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Abstract

Introduction Since its inception in the 20th century, ultrasonography has been the preserve of radiologists, aside from certain specific uses, such as echocardiography in cardiology, and vascular access scans for critical care clinicians. Recently, ultrasonography training programmes aimed at non-radiologists have become available – spanning diagnostic and interventional imaging. The Royal Colleges of Emergency Medicine, Anaesthetics and Physicians all stipulate varying degrees of competency which doctors must demonstrate to complete postgraduate clinical training. Diagnostic imaging by treating clinicians may allow rapid detection of serious pathology, leading to timely treatment initiation. This cross-sectional study aimed to assess the current prevalence of ultrasound training and use across medical, critical care and emergency department clinicians of all grade. Methods An electronic data capture tool was created using Google Forms – cloud-based questionnaire building software. Questions were co-authored by all authors of this abstract, and refined across multiple iterations until wording was clear and unambiguous. Ethical review was not required (Heath Research Authority decision aid tool). Invitations to participate were distributed to clinicians working in critical care emergency medicine, and acute medicine across 6 hospitals in the West Midlands, UK. Results were compiled into a database for analysis. Results 74 responses were received – 40% junior trainee doctors, 27% middle grade doctors, 22% consultant doctors, and 11% non-medical practitioners. 78% of respondents used ultrasound and 55% reported making clinical decisions based on findings, though only 40% had received formal ultrasound training. Those who had not received training often reported achieving competency through informal training with colleagues. Conclusion Many ultrasound practitioners have not been formally trained, which may raise concerns about governance and diagnostic quality assurance. Further work is needed to assess barriers to formal training, and to ensure that all clinical decisions are based on images attained by competent practitioners.

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© Copyright 2019 Morressier GmbH.
All rights reserved.