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Are young physicians prepared to perform focused assessment with sonography in trauma examination?
American Journal of Emergency Medicine xxx (2015) xxx–xxx
Contents lists available at ScienceDirect
American Journal of Emergency Medicine journal homepage: www.elsevier.com/locate/ajem
Correspondence
Are young physicians prepared to perform focused assessment with sonography in trauma examination?☆ To the Editor, In a recent article, O'Dochartaigh and Douma [1] present a systematic review of prehospital ultrasound of the abdomen and thorax, which changes trauma patient management. This article prompted us to conduct a study on young physicians preparing for performing focused assessment with sonography for trauma (FAST). Trauma is one of the most common causes of death in the young population with age group between 1 and 45 years. Blunt abdominal trauma is very common, and the prevalence of intraabdominal injury after it has been reported to be as high as 12% to 15%. The FAST is a particular sonographic examination that has gained acceptance as a screening test in both blunt and penetrating abdominal trauma [2]. Focused assessment with sonography for trauma is the most common US study performed by emergency physicians [3]. The FAST examination, as defined by international consensus, focuses on the dependent portions of the peritoneal cavity, the splenorenal recess, the hepatorenal recess (Morrison's pouch), and rectovesical/rectovaginal recesses [4]. In 1996, Ali et al [5] reported that a focused trauma US workshop significantly increased the ability of general surgeon residents and attending staff to identify intraperitoneal fluid. In this study, we evaluated the knowledge of FAST among junior physicians, participating in emergency medicine training organized by Department of Emergency Medicine, Medical University of Warsaw. The study involved 60 physicians from various medical universities in Poland. The research tool was a questionnaire survey. Of the 60 physicians participating in this study, only 5.0% declared that during their medical studies, they attended in theoretical and practical training in FAST; 51.7% participated in theoretical training; and 43.4% in general did not have such training during medical studies. Of the people, 93.3% claimed that such training should be mandatory training during studies. Of the participants, 23.3% were able to develop abbreviation FAST, whereas only 35.0% were able correctly identify all 4 touchdowns ultrasound scans, 11.7% were able identify 3 locations, 3.3% were able identify 1 location, whereas 50% of people could not identify the correct location of any touchdowns during the test FAST. Of the respondents, 90% indicated multiple-organ failure as a situation in which FAST examination should be done. All respondents recognized the FAST examination as a practical tool in patient assessment. In conclusion, the new medical knowledge in the field of research FAST is insufficient. It seems necessary to implement a mandatory FAST training during medical studies.
Zenon Truszewski PhD, MD Lukasz Szarpak PhD, DPH, EMT-P⁎ Department of Emergency Medicine, Medical University of Warsaw Warsaw, Poland ⁎Corresponding author at: Department of Emergency Medicine Medical University of Warsaw, Lindleya Str. 4, 02-005 Warsaw, Poland Tel.: +48 500186225 E-mail address: [email protected] Andrzej Kurowski PhD, MD Department of Anesthesiology, Cardinal Wyszynski National Institute of Cardiology, Warsaw, Poland Piotr Adamczyk MS Student Research Circle at the Department of Emergency Medicine Medical University of Warsaw, Warsaw, Poland Silvia Samarin PhD, MD Department of Cardiology, University Medical Centre, Ljubljana, Slovenia Lukasz Czyzewski PhD, RN Department of Nephrologic Nursing, Medical University of Warsaw Warsaw, Poland http://dx.doi.org/10.1016/j.ajem.2015.10.045
References [1] O'Dochartaigh D, Douma M. Prehospital ultrasound of the abdomen and thorax changes trauma patient management: a systematic review. Injury 2015. http://dx. doi.org/10.1016/j.injury.2015.07.007 [pii: S0020-1383(15)00419-2]. [2] Rozycki GS, Ochsner MG, Jaffin JH, Champion HR. Prospective evaluation of surgeons' use of ultrasound in the evaluation of trauma patients. J Trauma 1993; 34(4):516–26. [3] Goodman TR, Scoutt LM, Brink JA. A survey of emergency physician–performed ultrasound: implications for academic radiology departments. J Am Coll Radiol 2011;8(9): 631–4. http://dx.doi.org/10.1016/j.jacr.2011.03.010. [4] Scalea TM, Rodriguez A, Chiu WC, Brenneman FD, Fallon Jr WF, Kato K, et al. Focused assessment with sonography for trauma (FAST): results from an international consensus conference. J Trauma 1999;46(3):466–72. [5] Ali J, Rozycki GS, Campbell JP, Boulanger BR, Waddell JP, Gana TJ. Trauma ultrasound workshop improves physician detection of peritoneal and pericardial fluid. J Surg Res 1996;63(1):275–9.
☆ Conflict of interest statement: No conflict of interest to declare. 0735-6757/© 2015 Elsevier Inc. All rights reserved.
Please cite this article as: Truszewski Z, et al, Are young physicians prepared to perform focused assessment with sonography in trauma examination?, Am J Emerg Med (2015), http://dx.doi.org/10.1016/j.ajem.2015.10.045
Contents lists available at ScienceDirect
American Journal of Emergency Medicine journal homepage: www.elsevier.com/locate/ajem
Correspondence
Are young physicians prepared to perform focused assessment with sonography in trauma examination?☆ To the Editor, In a recent article, O'Dochartaigh and Douma [1] present a systematic review of prehospital ultrasound of the abdomen and thorax, which changes trauma patient management. This article prompted us to conduct a study on young physicians preparing for performing focused assessment with sonography for trauma (FAST). Trauma is one of the most common causes of death in the young population with age group between 1 and 45 years. Blunt abdominal trauma is very common, and the prevalence of intraabdominal injury after it has been reported to be as high as 12% to 15%. The FAST is a particular sonographic examination that has gained acceptance as a screening test in both blunt and penetrating abdominal trauma [2]. Focused assessment with sonography for trauma is the most common US study performed by emergency physicians [3]. The FAST examination, as defined by international consensus, focuses on the dependent portions of the peritoneal cavity, the splenorenal recess, the hepatorenal recess (Morrison's pouch), and rectovesical/rectovaginal recesses [4]. In 1996, Ali et al [5] reported that a focused trauma US workshop significantly increased the ability of general surgeon residents and attending staff to identify intraperitoneal fluid. In this study, we evaluated the knowledge of FAST among junior physicians, participating in emergency medicine training organized by Department of Emergency Medicine, Medical University of Warsaw. The study involved 60 physicians from various medical universities in Poland. The research tool was a questionnaire survey. Of the 60 physicians participating in this study, only 5.0% declared that during their medical studies, they attended in theoretical and practical training in FAST; 51.7% participated in theoretical training; and 43.4% in general did not have such training during medical studies. Of the people, 93.3% claimed that such training should be mandatory training during studies. Of the participants, 23.3% were able to develop abbreviation FAST, whereas only 35.0% were able correctly identify all 4 touchdowns ultrasound scans, 11.7% were able identify 3 locations, 3.3% were able identify 1 location, whereas 50% of people could not identify the correct location of any touchdowns during the test FAST. Of the respondents, 90% indicated multiple-organ failure as a situation in which FAST examination should be done. All respondents recognized the FAST examination as a practical tool in patient assessment. In conclusion, the new medical knowledge in the field of research FAST is insufficient. It seems necessary to implement a mandatory FAST training during medical studies.
Zenon Truszewski PhD, MD Lukasz Szarpak PhD, DPH, EMT-P⁎ Department of Emergency Medicine, Medical University of Warsaw Warsaw, Poland ⁎Corresponding author at: Department of Emergency Medicine Medical University of Warsaw, Lindleya Str. 4, 02-005 Warsaw, Poland Tel.: +48 500186225 E-mail address: [email protected] Andrzej Kurowski PhD, MD Department of Anesthesiology, Cardinal Wyszynski National Institute of Cardiology, Warsaw, Poland Piotr Adamczyk MS Student Research Circle at the Department of Emergency Medicine Medical University of Warsaw, Warsaw, Poland Silvia Samarin PhD, MD Department of Cardiology, University Medical Centre, Ljubljana, Slovenia Lukasz Czyzewski PhD, RN Department of Nephrologic Nursing, Medical University of Warsaw Warsaw, Poland http://dx.doi.org/10.1016/j.ajem.2015.10.045
References [1] O'Dochartaigh D, Douma M. Prehospital ultrasound of the abdomen and thorax changes trauma patient management: a systematic review. Injury 2015. http://dx. doi.org/10.1016/j.injury.2015.07.007 [pii: S0020-1383(15)00419-2]. [2] Rozycki GS, Ochsner MG, Jaffin JH, Champion HR. Prospective evaluation of surgeons' use of ultrasound in the evaluation of trauma patients. J Trauma 1993; 34(4):516–26. [3] Goodman TR, Scoutt LM, Brink JA. A survey of emergency physician–performed ultrasound: implications for academic radiology departments. J Am Coll Radiol 2011;8(9): 631–4. http://dx.doi.org/10.1016/j.jacr.2011.03.010. [4] Scalea TM, Rodriguez A, Chiu WC, Brenneman FD, Fallon Jr WF, Kato K, et al. Focused assessment with sonography for trauma (FAST): results from an international consensus conference. J Trauma 1999;46(3):466–72. [5] Ali J, Rozycki GS, Campbell JP, Boulanger BR, Waddell JP, Gana TJ. Trauma ultrasound workshop improves physician detection of peritoneal and pericardial fluid. J Surg Res 1996;63(1):275–9.
☆ Conflict of interest statement: No conflict of interest to declare. 0735-6757/© 2015 Elsevier Inc. All rights reserved.
Please cite this article as: Truszewski Z, et al, Are young physicians prepared to perform focused assessment with sonography in trauma examination?, Am J Emerg Med (2015), http://dx.doi.org/10.1016/j.ajem.2015.10.045