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Actual use of pocket-sized ultrasound devices for cardiovascular examination by trained physicians during a hospitalist rotation

机译:在医院旋转期间,训练有素的医生进行心血管检查的实际使用

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BackgroundIn actual clinical practice as opposed to published studies, the application of bedside ultrasound requires a perception of need, confidence in one's skills, and convenience.ObjectiveAs the frequency of ultrasound usage is evidence to its perceived value in patient care, we observed the pattern of autonomous use of a pocket-sized device (PSD) by ultrasound-trained residents during a night hospitalist rotation.MethodsConsecutive internal medicine residents ( n= 24), trained in a cardiac limited ultrasound examination (CLUE) as a mandatory part of their curriculum, were sampled on their PSD use after their admitting nights, regarding perceived necessity, deterring factors, detected abnormalities, and imaging difficulties. A detailed analysis was performed with one resident who used a PSD on every admission to compare the proportion of abnormal CLUEs and utility in patients with and without a perceived need.ResultsResidents admitted 542 patients (mean age: 55±17 years, range: 17–95 years) during 101 shifts and performed CLUE on 230 patients (42%, range: 17–85%). Residents elected not to scan 312 (58%) patients due to 1) lack of perceived necessity (231, 74%), 2) time constraints (44, 14%), and 3) patient barriers (37, 12%). In the detailed analysis ( n= 71), the resident felt CLUE was necessary in 32 (45%) patients versus unnecessary in 39 (55%) patients, with abnormality rates of 50% versus 20.5% ( p= 0.01) and utility rates of 28.1% versus 15.4% ( p= 0.25), respectively.ConclusionWhen unbiased residents acting as hospitalists are provided with a PSD to augment initial cardiac examination, usage is frequent and suggests clinical value in hospital medicine.
机译:背景技术与发表的研究相反,床边超声的应用需要对需求的看法,对一个人的技能的信心,以及方便。妨碍超声使用的频率是其在患者护理中的有价值的证据,我们观察了这种模式在夜间病人旋转期间,通过超声培训的居民自主使用口袋尺寸的居民。方法中的中医居民(n = 24),以心脏有限的超声检查(线索)培训为其课程的强制性部分,在他们的PSD使用后对他们承认的夜晚进行了抽样,关于感知必要性,阻止因素,检测到的异常和成像困难。详细分析与一家居民一起使用PSD,每次录取都会比较患者的异常线索和效用的比例,而没有感知的需求。征收542名患者(平均年龄:55±17岁,范围:17- 95年)在101次班次和230名患者中进行的线索(42%,范围:17-85%)。 Residents elected not to scan 312 (58%) patients due to 1) lack of perceived necessity (231, 74%), 2) time constraints (44, 14%), and 3) patient barriers (37, 12%).在详细分析(n = 71)中,居民毛毡线索在32例(45%)患者中是必需的,在39名(55%)患者中不必要,异常率为50%,而20.5%(P = 0.01)和公用事业费率分别为15.4%(p = 0.25),分别为15.4%(P = 0.25)。当为住院医生提供PSD以增加初始心脏检查时的非偏见居民,使用频繁,暗示医院医学的临床价值。

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