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Detection of soft tissue foreign bodies by nurse practitioner-performed ultrasound

机译:护士执业超声检查软组织异物

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Background This study aimed to evaluate the accuracy of emergency nurse practitioner (NP)-performed point-of-care ultrasound (POCUS) for the detection of soft tissue foreign bodies (FBs). Methods Following a 2-h training session, ten NPs were assessed on their ability to detect various FBs in an experimental model. FBs (wood, metal and plastic) were inserted randomly into eight experimental models (uncooked chicken thighs) by an independent observer. Control experimental models had no FB inserted, but all had a 1-cm incision made on their surface. NPs, blinded to the type of model, were then assessed on their ability to detect the FBs by ultrasound examination using high-frequency linear transducers (Toshiba Nemio). Models were also scanned by two experienced emergency physicians (EPs) as a further control. Results Overall, NP-performed POCUS detected 47 of the 60 foreign bodies with a sensitivity, specificity, positive predictive value and negative predictive value of 78.3%, 50%, 82% and 43%, respectively, compared with 83.3%, 75%, 90.9% and 60% for EPs. Sensitivity for detecting specific types of FB was 95%, 85% and 50% for wood, metal and plastic, respectively, for NP-performed POCUS, compared with 100%, 100% and 50% in the EP group. Conclusions NPs with no previous ultrasound experience can detect soft tissue FBs with accuracy comparable to that of EPs in an experimental model. Test sensitivity was high for wood and metal foreign bodies. Specificity was generally low.
机译:背景技术本研究旨在评估急诊执业医师(NP)进行的即时护理超声(POCUS)检测软组织异物(FBs)的准确性。方法经过2小时的训练,评估了10个NP在实验模型中检测各种FB的能力。由独立观察者将FB(木材,金属和塑料)随机插入八个实验模型(未煮熟的鸡大腿)中。对照实验模型未插入FB,但所有模型均在其表面上做了1厘米的切口。然后,通过使用高频线性换能器(Toshiba Nemio)进行超声检查,对不了解模型类型的NP评估其检测FB的能力。还由两名经验丰富的急诊医师(EP)扫描了模型,作为进一步的对照。结果总体而言,NP执行的POCUS检测到60个异物中的47个,其敏感性,特异性,阳性预测值和阴性预测值分别为78.3 %,50 %,82 %和43 %,而83.3 EP的百分比,75%,90.9%和60%。 NP执行的POCUS对木材,金属和塑料检测特定类型FB的灵敏度分别为95%,85%和50%,而EP中的灵敏度分别为100%,100%和50%组。结论以前没有超声检查经验的NP可以检测到软组织FB,其准确性与实验模型中的EP相当。对木材和金属异物的测试灵敏度很高。特异性一般较低。

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