Paramediklerin Kısa Eğitim Modülü Sonrasında Genişletilmiş Acil Travma Ultrasonografi Görüntülerini Tanıyabilmesi

Abstract

Amaç: Çalışmamızda Travmada sonografi ile odaklanmış değerlendirme (FAST) eğitimi için bir saatlik bir kısa eğitim modelinin daha önce bu konuda eğitimi olmayan paramediklerin görsel becerisini artırıp artırmayacağını test etmek amaçlandı. Gereç ve Yöntem: Çalışmamız prospektif tasarlanmış kontrolsüz deneysel çalışma olarak planlandı. E-FAST Ultrasonografi (USG) konusunda deneyimsiz 27 paramediğe kısa eğitim modülü ilk test uygulandı ve eğitim sonrası son test uygulanarak normal ve patolojik vaka görüntülerini ayırmadaki başarıları değerlendirildi. Bulgular: Katılımcıların %55,6’sı kadın, %74,1’i yeni mezun ve yaş ortalamaları 21,58 ± 9,60 yıldı. İlk test ve son teste katılımcıların verdikleri yanıtlar değerlendirildiğinde; ilk testte birçok soruda katılımcıların %31,9 unda anlayamadım yanıtı var iken eğitim sonrasında %82,9 tüm testler için fikir yürütülebildiği görüldü. Katılımcıların ilk test ve son teste doğru yanıt oranlarına bakıldığında istatistiksel olarak anlamlı artış görüldü (p<0,001). Sonuç: Çalışmamızda hiçbir E-FAST USG deneyimi olmayan paramediklerin eğitim sonrasında normal ve anormal vaka görüntülerini ayırt etmede becerileri anlamlı miktarda arttı ve başarılarının istatistiksel olarak anlamlı derecede arttığı görüldü.

Keywords

• Paramedik
• FAST
• USG

Paramedics Recognizing Extended Trauma Ultrasonography Images after Short Training Module

Abstract

Objective: Our study aimed to test whether a one-hour short training model for Focused Assessment with Sonography in Trauma (FAST) training would increase the visual skills of paramedics who had no previous training in this field. Material and Method: Our study was planned as a prospective, uncontrolled experimental study. A short training module was applied to 27 paramedics who were inexperienced in E-FAST Ultrasonography (USG). The first test was applied and the final test was applied after the training and their success in distinguishing normal and pathological case images was evaluated. Results: 55.6% of the participants were women, 74.1% were new graduates, and their average age was 21.58 ± 9.60 years. When the answers given by the participants to the first test and the last test were evaluated; While 31.9% of the participants answered "I did not understand" to many questions in the first test, after the training, it was seen that 82.9% could form ideas for all tests. When the correct response rates of the participants to the first test and the last test were examined, a statistically significant increase was observed (p <0.001). Conclusion: In our study, the skills of paramedics who had no E-FAST USG experience in distinguishing between normal and abnormal case images increased significantly after the training, and their success was observed to increase statistically significantly.

Keywords

• Paramedic
• FAST
• USG.

References

1. Türk Dil Kurumu 2016 http://www.tdk.gov.tr.
2. İpekçi F. İlk ve Acil Yardım. In: Ertekin C, Taviloğlu K, Güloğlu R, Kurtoğlu M (Editör). Travma. First. İstanbul: İstanbul Medikal Yayıncılık; 2005;123-33.
3. Clarke JR, Trooskin SZ, Doshi PJ, Greenwald L, Mode CJ. Time to laparotomy for intra- abdominal bleeding from trauma does affect survival for delays up to 90 minutes. J Trauma 2002;52:420-5.
4. Audrey, A., Reichard, MPH. OTR., Suzanne, M., Marsh, MPA., Paul, H.,Moore, BSME., (2011). Fatal and Nonfatal Injuries Among Emergency Medical Technicians and Paramedics, Prehospital Emergency Care, 4 (15), 511-7.
5. Coşkun F, Akıncı E, Ceyhan MA, Sahin Kavaklı H. Our new stethoscope in the emergency department: handheld ultrasound. Ulus Travma Acil Cerrahi Derg 2011;17:488-92
6. American Institute of Ultrasound in M, American College of Emergency P. AIUM practice guideline for the performance of the focused assessment with sonography for trauma (FAST) examination. J Ultrasound Med 2014;33(11):2047-56.
7. Dulchavsky SA, Schwarz KL, Kirkpatrick AW, Billica RD, Williams DR, Diebel LN, et al. Prospective evaluation of thoracic ultrasound in the detection of pneumothorax. J Trauma 2001;50:201-5.
8. Kirkpatrick AW, Nicolaou S, Rowan K, Liu D, Cunningham J, Sargsyan AE, et al. Thoracic sonography for pneumothorax: the clinical evaluation of an operational space medicine spin-off. Acta Astronaut 2005;56:831- 8.

9. Kirkpatrick AW, Sirois M, Laupland KB, Liu D, Rowan K, Ball CG, et al. Hand-held thoracic sonography for detecting post-traumatic pneumothoraces: the Extended Focused Assessment with Sonography for Trauma (EFAST). J Trauma 2004;57(2):28895.
10. Salen PN, Melanson SW, Heller MB. The Focused Abdominal Sonography for Trauma (FAST) Examination: Considerations and Recommendations for Training Physicians in the Use of a New Clinical Tool. Academic Emergency Medicine 2000;7:162-8.
11. Shackford SR, Rogers FB, Osler TM, Trabulsy ME, Clauss DW, Vane DW. Focused abdominal sonogram for trauma: the learning curve of nonradiologist clinicians in detecting hemoperitoneum. J Trauma 1999;46:553-62; discussion 62-4.
12. Thomas B, Falcone RE, Vasquez D, et al. Ultrasound evaluation of blunt abdominal trauma: program implementation, initial experience, and learning curve. J Trauma 1997;42:384-8; discussion 8-90.
13. Frezza EE, Solis RL, Silich RJ, Spence RK, Martin M. Competency-based instruction to improve the surgical resident technique and accuracy of the trauma ultrasound. Am Surg 1999;65:884-8.
14. Swamy V, Brainin P, Biering-Sørensen T, Platz E. Ability of non-physicians to perform and interpret lung ultrasound: A systematic review. Eur J Cardiovasc Nurs. 2019 Apr 24:1474515119845972.
15. Marsh-Feiley G, Eadie L, Wilson P. Paramedic and physician perspectives on the potential use of remotely supported prehospital ultrasound. Rural Remote Health. 2018 Sep;18(3):4574.
16. Bøtker MT, Jacobsen L, Rudolph SS, Knudsen L. The role of point of care ultrasound in prehospital critical care: a systematic review. Scand J Trauma Resusc Emerg Med. 2018 Jun 26;26(1):51.
17. Byhahn C, Binbold TM, Zwissler B, Maier M, Walcher F. Prehospital ultrasound detects pericardial tamponade in a pregnant victim of stabbing assault. Resuscitation 2008; 76:146–148.
18. Walcher F, Weinlich M, Conrad G, Schweigkofler U, Breitkreutz R, Kirsching T, et al. Prehospital ultrasound imaging improves management of abdominal trauma. Br J Surg 2006; 93:238–242.
19. Strode CA, Rubal BJ, Gerhardt RT, Bulgrin JR, Boyd SYN. Wireless and satellite transmission of prehospital focused abdominal sonography for trauma. Prehosp Emerg Care 2003; 7:375–379.
20. Planas JH, Waseem M, Sigmon DF. Trauma Primary Survey. [Updated 2023 Apr 10]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-.