%0 Journal Article
%T Thorax, Trachea, and Lung Ultrasonography in Emergency and Critical Care Medicine: Assessment of an Objective Structured Training Concept
%A Raoul Breitkreutz
%A Martina Dutin¨¦
%A Patrick Scheiermann
%A Dorothea Hempel
%A Sandy Kujumdshiev
%A Hanns Ackermann
%A Florian Hartmut Seeger
%A Armin Seibel
%A Felix Walcher
%A Tim Oliver Hirche
%J Emergency Medicine International
%D 2013
%I Hindawi Publishing Corporation
%R 10.1155/2013/312758
%X Background and Study objective. Focused lung ultrasound (LUS) examinations are important tools in critical care medicine. There is evidence that LUS can be used for the detection of acute thoracic lesions. However, no validated training method is available. The goal of this study was to develop and assess an objective structured clinical examination (OSCE) curriculum for focused thorax, trachea, and lung ultrasound in emergency and critical care medicine (THOLUUSE). Methods. 39 trainees underwent a one-day training course in a prospective educational study, including lectures in sonoanatomy and -pathology of the thorax, case presentations, and hands-on training. Trainees¡¯ pre- and posttest performances were assessed by multiple choice questionnaires, visual perception tests by interpretation video clips, practical performance of LUS, and identification of specific ultrasound findings. Results. Trainees postcourse scores of correct MCQ answers increased from to (mean¡À SD; ); visual perception skills increased from to ( ); practical ultrasound skills improved, and correct LUS was performed in 94%. Subgroup analysis revealed that learning success was independent from the trainees¡¯ previous ultrasound experience. Conclusions. THOLUUSE significantly improves theoretical and practical skills for the diagnosis of acute thoracic lesions. We propose to implement THOLUUSE in emergency medicine training. 1. Introduction Focused lung ultrasound (LUS) examinations are increasingly important diagnostic tools in emergency and critical care medicine [1¨C4]. A broad area of medicine, including internal medicine [5, 6] and traumatology [1, 7], can benefit from its time and cost-effectiveness and absence of radiation exposure, as well as the reduction of need for transportations of ventilated patients. Using portable ultrasound devices, LUS is now available in virtually all in- and out-of-hospital scenarios [8]. However, unlike focused assessment with sonography in blunt trauma (FAST) that has become a standard procedure, ultrasound examination of thorax and lungs has only recently been established for workup of critically ill patients [9]. Still, when a lesion is suspected, chest X-rays (CXR) or CT scans remain the diagnostic procedures of choice. Apart from echocardiography, noninvasive examination of the chest by ultrasound is not routinely performed in most centers although many investigations support its use [4, 10, 11]. While the detection of fluid such as in hematothorax or pleural effusion (PLE) has been described as relatively simple [12] and ultrasound-guided
%U http://www.hindawi.com/journals/emi/2013/312758/