Skip to main content

Advertisement

Log in

Results of short-term training of naïve physicians in focused general ultrasonography in an intensive-care unit

  • Brief Report
  • Published:
Intensive Care Medicine Aims and scope Submit manuscript

Abstract

Rationale and objectives

To evaluate limited training of ICU physicians without knowledge of ultrasound in performing basic general ultrasonography.

Design and setting

A prospective, observational, study conducted in a 14-bed MICU.

Patients

Seventy-seven critically ill patients (38 females) aged 64 ± 16 years, with a SAPS II score of 47 ± 21, 49 of whom (64%) were receiving mechanical ventilation.

Methods

After 8.5 h of training comprising a 2.5 h didactic course that included essential views of normal and pathologic conditions and three hands-on sessions of 2 h each, one of eight ICU residents and the radiologist on duty performed the same examination in a blind manner. The questions addressed concerned the presence of pleural effusion, intra-abdominal effusion, acute cholecystitis, intrahepatic biliary duct dilation, obstructive uropathy, chronic renal disease, and deep venous thrombosis.

Measurements and main results

The answers to 129 questions were analyzed. The possible presence of pleural effusion, and arguments for the presence of urinary tract obstruction and chronic renal insufficiency, were the questions most frequently addressed. Residents answered 84.4% of the questions correctly [Kappa: 0.66, CI 95% (0.32–1.12)]. Most of the discrepancies concerned small non-drainable pleural or abdominal effusions. For questions with a potential therapeutic impact, residents answered 95% of the questions correctly [Kappa 0.86, CI 95% (0.75–1.04)]. Residents completed the examination in 37 ± 39 min compared with 296 ± 487 min for the radiologists (P = 0.004).

Conclusions

These results suggest that after brief focused training, intensive-care unit physicians without previous knowledge of ultrasonography can competently perform basic general ultrasonic examinations.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

References

  1. Vieillard-Baron A, Charron C, Chergui K, Peyrouset O, Jardin F (2006) Bedside echocardiographic evaluation of hemodynamics in sepsis: is a qualitative evaluation sufficient? Intensive Care Med 32:1547–1552

    Article  PubMed  Google Scholar 

  2. Vieillard-Baron A, Prin S, Chergui K, Dubourg O, Jardin F (2003) Hemodynamic instability in sepsis: bedside assessment by Doppler echocardiography. Am J Respir Crit Care Med 168:1270–1276

    Article  PubMed  Google Scholar 

  3. Vieillard-Baron A, Slama M, Cholley B, Janvier G, Vignon P (2008) Echocardiography in the intensive-care unit: from evolution to revolution? Intensive Care Med 34:243–249

    Article  PubMed  Google Scholar 

  4. Vignon P, Dugard A, Abraham J, Belcour D, Gondran G, Pepino F, Marin B, Francois B, Gastinne H (2007) Focused training for goal-oriented hand-held echocardiography performed by noncardiologist residents in the intensive-care unit. Intensive Care Med 33:1795–1799

    Article  PubMed  Google Scholar 

  5. Charron C, Prat G, Caille V, Belliard G, Lefevre M, Aegerter P, Boles JM, Jardin F, Vieillard-Baron A (2007) Validation of a skills assessment scoring system for transesophageal echocardiographic monitoring of hemodynamics. Intensive Care Med 33:1712–1718

    Article  PubMed  Google Scholar 

  6. Schacherer D, Klebl F, Goetz D, Buettner R, Zierhut S, Schoelmerich J, Langgartner J (2007) Abdominal ultrasound in the intensive-care unit: a 3-year survey on 400 patients. Intensive Care Med 33:841–844

    Article  PubMed  Google Scholar 

  7. Lichtenstein D, Axler O (1993) Intensive use of general ultrasound in the intensive-care unit. Prospective study of 150 consecutive patients. Intensive Care Med 19:353–355

    Article  PubMed  CAS  Google Scholar 

  8. Slasky BS, Auerbach D, Skolnick ML (1983) Value of portable real-time ultrasound in the ICU. Crit Care Med 11:160–164

    Article  PubMed  CAS  Google Scholar 

  9. Jang T, Sineff S, Naunheim R, Aubin C (2004) Residents should not independently perform focused abdominal sonography for trauma after 10 training examinations. J Ultrasound Med 23:793–797

    PubMed  Google Scholar 

  10. Shackford SR, Rogers FB, Osler TM, Trabulsy ME, Clauss DW, Vane DW (1999) Focused abdominal sonogram for trauma: the learning curve of nonradiologist clinicians in detecting hemoperitoneum. J Trauma 46:553–562 discussion 562–554

    Article  PubMed  CAS  Google Scholar 

  11. Vigneau C, Baudel JL, Guidet B, Offenstadt G, Maury E (2005) Sonography as an alternative to radiography for nasogastric feeding tube location. Intensive Care Med 31:1570–1572

    Article  PubMed  Google Scholar 

  12. Maury E, Guglielminotti J, Alzieu M, Guidet B, Offenstadt G (2001) Ultrasonic examination: an alternative to chest radiography after central venous catheter insertion? Am J Respir Crit Care Med 164:403–405

    PubMed  CAS  Google Scholar 

  13. Doelken P, Strange C (2003) Chest ultrasound for “Dummies”. Chest 123:332–333

    Article  PubMed  Google Scholar 

  14. Vignon P, Frank MB, Lesage J, Mucke F, Francois B, Normand S, Bonnivard M, Clavel M, Gastinne H (2004) Hand-held echocardiography with Doppler capability for the assessment of critically-ill patients: is it reliable? Intensive Care Med 30:718–723

    Article  PubMed  Google Scholar 

  15. Manasia AR, Nagaraj HM, Kodali RB, Croft LB, Oropello JM, Kohli-Seth R, Leibowitz AB, DelGiudice R, Hufanda JF, Benjamin E, Goldman ME (2005) Feasibility and potential clinical utility of goal-directed transthoracic echocardiography performed by noncardiologist intensivists using a small hand-carried device (SonoHeart) in critically ill patients. J Cardiothorac Vasc Anesth 19:155–159

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Eric Maury.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Chalumeau-Lemoine, L., Baudel, JL., Das, V. et al. Results of short-term training of naïve physicians in focused general ultrasonography in an intensive-care unit. Intensive Care Med 35, 1767–1771 (2009). https://doi.org/10.1007/s00134-009-1531-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00134-009-1531-3

Keywords

Navigation