FAST ultrasound, nurse performed ultrasound, trauma patients, POCUS, emergency department, fluid resuscitation, septic shock, ultrasound accuracy, nurse training, emergency medicine
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Abstract
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Abstract
This study evaluates the accuracy of FAST ultrasound examinations performed by nurses in detecting fluid collections in trauma patients.
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[...] Emergency physicians approved the results of ultrasounds performed by nurses in 99.1% of cases. They approved 100% of cases at T of cases at 3 hours and 100% of cases at 6 hours. The results of these ultrasounds led to a modification of the liquid care management of patients in 83.7% of cases. In fact, the POCUS examinations performed by nurses allowed to observe that: - the collapse of the VCI decreased when the liquid input approached the maximum tolerance level, - the B lines did not show a significant change according to the patient's liquid state. [...]
[...] Study protocol (ePhorte 2017/6798-1) approved by the institutional review board on the study site. The inclusion criteria for patients admitted to the USIC between October 2017 and February 2019 were: - presented signs and symptoms of dyspnea - age ? 18 years - cardiac cause of dyspnea - admission to the service [...]
[...] CI at 0.52 - 0.88), - almost perfect for left pleural effusion (0.85? CI 0.75 - 0.95) and pericardial effusion (0.95? CI 0.90 - 1.01). The possible clinical consequences are discussed solely based on a bibliographic review presented in the 'Discussion' section of the article, the aim being to complement rather than replace the doctors' examinations. The authors highlight this interest in circumstances where a qualified doctor is not immediately available or cannot be present during the required ultrasound. For severely ill patients, trained nurses can perform a faster triage, direct clinical management, and provide faster data on the physiological state of a patient and their prognosis. [...]
[...] (programme of the training and detailed examination in the publication) Ethics: No indication of informed consent from patients or study participants. The results of the effusion diagnoses performed by FAST by the nurses were recorded as positive/negative/equivocal for each patient. The reference examinations used for the study were: - operative report; - the imaging findings by formal computed tomography with contrast or ultrasound performed by a radiologist blinded to the study; - the patient's subsequent clinical evolution during the duration of his hospitalization. Outcome areas (domaines). [...]
[...] The injuries were mainly caused by road accidents. 4 experienced ambulance staff affected by triage followed: - 4 hours of theoretical training and - 4 hours of practical training, dispensed by a radiologist, to the practice of FAST in the detection of hemorrhages. Ethics: - informed consent of patients obtained - informed consent requested from the paramedics who performed the FAST. The results of the FAST (static views in mode performed by paramedics have been recorded as positive/negative for each patient. [...]
