TRAUMA ULTRASOUND WORKSHOP IMPROVES PHYSICIAN DETECTION OF PERITONEALAND PERICARDIAL FLUID

Hemoperitoneum represents a major indication for surgical intervention after trauma. To improve the ability of surgical residents and trauma physicians to detect intraperitoneal and pericardial fluid using ultr asound as a diagnostic modality, we conducted a focused trauma ultraso und workshop consisting of discussion of ultrasound physics, demonstra tion of instrumentation, review of pertinent literature, videotaped de monstration, and ''hands-on'' teaching of the skills utilizing live pa tient models. The ultrasound probes were placed in four standard locat ions-right and left upper quadrants, epigastrium, and Pouch of Douglas . Skills acquisition was tested by pre- and postworkshop performance o n 12 sonograms (3 for each location, 6 were positive for fluid). Thirt y physicians (21 residents and 9 staff: Group I) who attended the work shop were compared to 30 matched controls (Group II), The results (mea ns +/- SD) were as follows (R = number right, I = number of ''indeterm inate,'' W = number of wrong responses out of 12, P < 0.05 compared t o Group II): [GRAPHICS] False positive (%) and false negative (%) decr eased from 12.9 +/- 1.5 to 8.9 +/- 5.3 and 15.0 +/- 10.4 to 5.0 +/- 5. 2, respectively, in Group I but did not change in Group II. Postworksh op ability to detect fluid was significantly (P < 0.05) improved, with no major differences between residents and staff. Our data suggest th at these workshops can significantly improve the skills of nonradiolog ists in sonographic identification of pericardial and intraperitoneal fluid and should therefore be considered an essential component of ult rasound training for trauma physicians. (C) 1996 Academic Press, Inc.