Ultrasound detection of the sliding lung sign by prehospital critical care providers
Abstract Background The presence of the sonographic sliding lung sign (SLS) is a sensitive indicator for the absence of a pneumothorax. Objective The aim of this study was to determine if prehospital critical care providers (PHCPs) can acquire and maintain the necessary skills to determine the prese...
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| Veröffentlicht in: | The American journal of emergency medicine 2012-03, Vol.30 (3), p.485-488 |
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| creator | Lyon, Matthew, MD Walton, Perry, DO Bhalla, Valori, MD Shiver, Stephen A., MD |
| description | Abstract Background The presence of the sonographic sliding lung sign (SLS) is a sensitive indicator for the absence of a pneumothorax. Objective The aim of this study was to determine if prehospital critical care providers (PHCPs) can acquire and maintain the necessary skills to determine the presence or absence of the SLS following a brief tutorial. Methods This was a blinded randomized observational trial using a cadaveric model. The model was randomized to esophageal intubation (negative SLS) or tracheal intubation (positive SLS), and a SonoSite 180 plus (Bothel, WA) machine was used for the examination. After a 9-month period, the PHCPs were reevaluated without additional instruction. Results There were 8 PHCPs. A total of 6 intubations were performed yielding a total of 48 trials. The presence or absence of the SLS was correctly identified in 46 of the 48 trials, resulting in a sensitivity and specificity of 96.9% (95% confidence interval [CI], 89.6%-99.1%) and 93.8% (95% CI, 93.8%-79.3%), respectively. At the 9-month follow-up, 7 of the original PHCPs were available to participate. A total of 8 intubations were performed yielding a total of 56 trials. The presence or absence of the SLS was correctly identified in all 56 trials, resulting in a sensitivity and specificity of 100% (95% CI, 93.6%-100%). Conclusion Prehospital critical care providers can accurately determine the presence or absence of the sonographic SLS following a brief tutorial and retain the skill set following a 9-month interval. |
| doi_str_mv | 10.1016/j.ajem.2011.01.009 |
| format | Article |
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Objective The aim of this study was to determine if prehospital critical care providers (PHCPs) can acquire and maintain the necessary skills to determine the presence or absence of the SLS following a brief tutorial. Methods This was a blinded randomized observational trial using a cadaveric model. The model was randomized to esophageal intubation (negative SLS) or tracheal intubation (positive SLS), and a SonoSite 180 plus (Bothel, WA) machine was used for the examination. After a 9-month period, the PHCPs were reevaluated without additional instruction. Results There were 8 PHCPs. A total of 6 intubations were performed yielding a total of 48 trials. The presence or absence of the SLS was correctly identified in 46 of the 48 trials, resulting in a sensitivity and specificity of 96.9% (95% confidence interval [CI], 89.6%-99.1%) and 93.8% (95% CI, 93.8%-79.3%), respectively. At the 9-month follow-up, 7 of the original PHCPs were available to participate. A total of 8 intubations were performed yielding a total of 56 trials. The presence or absence of the SLS was correctly identified in all 56 trials, resulting in a sensitivity and specificity of 100% (95% CI, 93.6%-100%). Conclusion Prehospital critical care providers can accurately determine the presence or absence of the sonographic SLS following a brief tutorial and retain the skill set following a 9-month interval.</description><identifier>ISSN: 0735-6757</identifier><identifier>EISSN: 1532-8171</identifier><identifier>DOI: 10.1016/j.ajem.2011.01.009</identifier><identifier>PMID: 21334155</identifier><identifier>CODEN: AJEMEN</identifier><language>eng</language><publisher>New York, NY: Elsevier Inc</publisher><subject>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy ; Auscultation ; Biological and medical sciences ; Cadavers ; Clinical Competence ; Clinical death. Palliative care. Organ gift and preservation ; Clinical medicine ; Critical care ; Education, Continuing ; Education, Nursing, Continuing ; Emergency ; Emergency medical care ; Emergency Medical Services ; Emergency Medical Technicians - education ; Esophagus ; Humans ; Intensive care medicine ; Intubation ; Intubation, Gastrointestinal ; Intubation, Intratracheal ; Medical sciences ; Paramedics ; Pleura - diagnostic imaging ; Pneumothorax - diagnostic imaging ; Sensitivity and Specificity ; Single-Blind Method ; Ultrasonic imaging ; Ultrasonography, Doppler ; Ventilators</subject><ispartof>The American journal of emergency medicine, 2012-03, Vol.30 (3), p.485-488</ispartof><rights>Elsevier Inc.</rights><rights>2012 Elsevier Inc.</rights><rights>2015 INIST-CNRS</rights><rights>Copyright © 2012 Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c468t-1bbb84c48acac583e1e71495a21affb1eea569d3a76c251f757152cd27b6d20b3</citedby><cites>FETCH-LOGICAL-c468t-1bbb84c48acac583e1e71495a21affb1eea569d3a76c251f757152cd27b6d20b3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.proquest.com/docview/1030948203?pq-origsite=primo$$EHTML$$P50$$Gproquest$$H</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995,64385,64387,64389,72469</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=25696988$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/21334155$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Lyon, Matthew, MD</creatorcontrib><creatorcontrib>Walton, Perry, DO</creatorcontrib><creatorcontrib>Bhalla, Valori, MD</creatorcontrib><creatorcontrib>Shiver, Stephen A., MD</creatorcontrib><title>Ultrasound detection of the sliding lung sign by prehospital critical care providers</title><title>The American journal of emergency medicine</title><addtitle>Am J Emerg Med</addtitle><description>Abstract Background The presence of the sonographic sliding lung sign (SLS) is a sensitive indicator for the absence of a pneumothorax. Objective The aim of this study was to determine if prehospital critical care providers (PHCPs) can acquire and maintain the necessary skills to determine the presence or absence of the SLS following a brief tutorial. Methods This was a blinded randomized observational trial using a cadaveric model. The model was randomized to esophageal intubation (negative SLS) or tracheal intubation (positive SLS), and a SonoSite 180 plus (Bothel, WA) machine was used for the examination. After a 9-month period, the PHCPs were reevaluated without additional instruction. Results There were 8 PHCPs. A total of 6 intubations were performed yielding a total of 48 trials. The presence or absence of the SLS was correctly identified in 46 of the 48 trials, resulting in a sensitivity and specificity of 96.9% (95% confidence interval [CI], 89.6%-99.1%) and 93.8% (95% CI, 93.8%-79.3%), respectively. At the 9-month follow-up, 7 of the original PHCPs were available to participate. A total of 8 intubations were performed yielding a total of 56 trials. The presence or absence of the SLS was correctly identified in all 56 trials, resulting in a sensitivity and specificity of 100% (95% CI, 93.6%-100%). Conclusion Prehospital critical care providers can accurately determine the presence or absence of the sonographic SLS following a brief tutorial and retain the skill set following a 9-month interval.</description><subject>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</subject><subject>Auscultation</subject><subject>Biological and medical sciences</subject><subject>Cadavers</subject><subject>Clinical Competence</subject><subject>Clinical death. Palliative care. Organ gift and preservation</subject><subject>Clinical medicine</subject><subject>Critical care</subject><subject>Education, Continuing</subject><subject>Education, Nursing, Continuing</subject><subject>Emergency</subject><subject>Emergency medical care</subject><subject>Emergency Medical Services</subject><subject>Emergency Medical Technicians - education</subject><subject>Esophagus</subject><subject>Humans</subject><subject>Intensive care medicine</subject><subject>Intubation</subject><subject>Intubation, Gastrointestinal</subject><subject>Intubation, Intratracheal</subject><subject>Medical sciences</subject><subject>Paramedics</subject><subject>Pleura - diagnostic imaging</subject><subject>Pneumothorax - diagnostic imaging</subject><subject>Sensitivity and Specificity</subject><subject>Single-Blind Method</subject><subject>Ultrasonic imaging</subject><subject>Ultrasonography, Doppler</subject><subject>Ventilators</subject><issn>0735-6757</issn><issn>1532-8171</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2012</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNp9kt-L1DAQx4Mo3nr6D_ggBRGfumaSpmlBDuTwFxz44N1zSJPpXWo3XZP2YP97p-zqwT0IQxLIZ359Zxh7DXwLHOoPw9YOuNsKDrDlZLx9wjagpCgb0PCUbbiWqqy10mfsRc4DJ7BS1XN2JkDKCpTasOubcU42T0v0hccZ3RymWEx9Md9hkcfgQ7wtxoWOHG5j0R2KfcK7Ke_DbMfCpTAHtz5sQvqZ7oPHlF-yZ70dM7463efs5svn68tv5dWPr98vP12VrqqbuYSu65rKVY111qlGIqCGqlVWgO37DhCtqlsvra6dUNBTI6CE80J3tRe8k-fs_TEuZf69YJ7NLmSH42gjTks2rdB1yxVoIt8-IodpSZGKM8Alb6tGcEmUOFIuTTkn7M0-hZ1NB4LMKrkZzCq5WSU3nIy35PTmFHrpduj_ufzVmIB3J8Bm0qpPNrqQHzjqsW6bhriPRw5JsvuAyWQXMDr0IdFcjJ_C_-u4eOTuxhDX6fzCA-aHfk0Whpuf63KsuwHAaTEaLv8AdPez3A</recordid><startdate>20120301</startdate><enddate>20120301</enddate><creator>Lyon, Matthew, MD</creator><creator>Walton, Perry, DO</creator><creator>Bhalla, Valori, MD</creator><creator>Shiver, Stephen A., MD</creator><general>Elsevier Inc</general><general>Elsevier</general><general>Elsevier Limited</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7T5</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>H94</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>M2O</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>Q9U</scope><scope>7X8</scope></search><sort><creationdate>20120301</creationdate><title>Ultrasound detection of the sliding lung sign by prehospital critical care providers</title><author>Lyon, Matthew, MD ; Walton, Perry, DO ; Bhalla, Valori, MD ; Shiver, Stephen A., MD</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c468t-1bbb84c48acac583e1e71495a21affb1eea569d3a76c251f757152cd27b6d20b3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2012</creationdate><topic>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</topic><topic>Auscultation</topic><topic>Biological and medical sciences</topic><topic>Cadavers</topic><topic>Clinical Competence</topic><topic>Clinical death. Palliative care. 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Objective The aim of this study was to determine if prehospital critical care providers (PHCPs) can acquire and maintain the necessary skills to determine the presence or absence of the SLS following a brief tutorial. Methods This was a blinded randomized observational trial using a cadaveric model. The model was randomized to esophageal intubation (negative SLS) or tracheal intubation (positive SLS), and a SonoSite 180 plus (Bothel, WA) machine was used for the examination. After a 9-month period, the PHCPs were reevaluated without additional instruction. Results There were 8 PHCPs. A total of 6 intubations were performed yielding a total of 48 trials. The presence or absence of the SLS was correctly identified in 46 of the 48 trials, resulting in a sensitivity and specificity of 96.9% (95% confidence interval [CI], 89.6%-99.1%) and 93.8% (95% CI, 93.8%-79.3%), respectively. At the 9-month follow-up, 7 of the original PHCPs were available to participate. A total of 8 intubations were performed yielding a total of 56 trials. The presence or absence of the SLS was correctly identified in all 56 trials, resulting in a sensitivity and specificity of 100% (95% CI, 93.6%-100%). Conclusion Prehospital critical care providers can accurately determine the presence or absence of the sonographic SLS following a brief tutorial and retain the skill set following a 9-month interval.</abstract><cop>New York, NY</cop><pub>Elsevier Inc</pub><pmid>21334155</pmid><doi>10.1016/j.ajem.2011.01.009</doi><tpages>4</tpages></addata></record> |
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| subjects | Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy Auscultation Biological and medical sciences Cadavers Clinical Competence Clinical death. Palliative care. Organ gift and preservation Clinical medicine Critical care Education, Continuing Education, Nursing, Continuing Emergency Emergency medical care Emergency Medical Services Emergency Medical Technicians - education Esophagus Humans Intensive care medicine Intubation Intubation, Gastrointestinal Intubation, Intratracheal Medical sciences Paramedics Pleura - diagnostic imaging Pneumothorax - diagnostic imaging Sensitivity and Specificity Single-Blind Method Ultrasonic imaging Ultrasonography, Doppler Ventilators |
| title | Ultrasound detection of the sliding lung sign by prehospital critical care providers |
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