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Training Boosts Bedside Ultrasound Use in ED


 

From the annual meeting of the American Institute for Ultrasound in Medicine

SAN DIEGO — After a simple training intervention, emergency physicians at a large tertiary-care hospital performed more than twice as many focused bedside ultrasound exams on pregnant patients as before the training.

“Pregnant women who get the ultrasound by the emergency physician are usually in and out of the department in 20-30 minutes,” Dr. Michael Antonis said in an interview during a poster session.

“Basically, you're looking for a heartbeat and anything worrisome in the adnexa,” explained Dr. Antonis, ultrasound fellowship director at the Georgetown University/Washington Hospital Center's emergency medicine residency program, Washington. “With those questions answered, they're out the door in 20-30 minutes. You don't have to send them to radiology. It's something that's done right at the bedside.”

In a 9-month study led by Dr. Antonis's associate, Dr. Elizabeth Pontius, a third-year resident in the emergency medicine residency program, researchers developed a training program for attending physicians in the ED. The program consisted of two modules: an online training module on how to use the bedside ultrasound machine in general, and a second training module describing how to use the machine for transabdominal and endocavity scans during pregnancy. Next, the attending physicians were assigned to dedicated “sounding” shifts with Dr. Antonis and Dr. Carolyn Phillips, also of Washington Hospital Center, in which they learned how to perform focused ultrasound exams.

After that training, Dr. Antonis and his associates reviewed all ultrasound exams during weekly quality-assurance reviews, and the total number of scans performed by each physician during the intervention period was counted. Before the intervention period, 31 physicians had performed a total of 645 transabdominal or endocavity pregnancy ultrasound exams. After the intervention, 34 physicians had performed 2,350 exams. That translated into a 264% increase in the number of scans performed during the 9-month intervention.

Disclosures: None was reported.

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