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The Effectiveness of an Informal Teaching Programme for Junior Doctors Identifying Pleural Effusions Using Ultrasound at the Bedside
  1. Maj Ross J Moy, Registrar in Emergency Medicine1,
  2. AL Chapman, Consultant Chest Physician2 and
  3. A Bapusamy, Consultant Radiologist3
  1. 1CT2 in Emergency Medicine, Defence Medical Deanery
  2. 2Respiratory Department, The Friarage Hospital, Northallerton
  3. 3Radiology Department, The Friarage Hospital, Northallerton
  1. James Cook University Hospital, Marton Road, Middlesbrough TS4 3BW rjmoy{at}doctors.org.uk

Abstract

Objectives The use of bedside ultrasound to localise pleural effusions has gained in popularity in recent years. We investigated whether or not junior doctors could accurately identify thoracic anatomical structures and localise pleural effusions using bedside ultrasound.

Methods Junior doctors were instructed by a consultant chest physician in the theory and practice of using ultrasound to localise pleural effusions, and then instructed in the method of inserting a Seldinger chest drain. Juniors were instructed to record a scan picture, including labelling of relevant structures. We then conducted a review of 52 images, noting indications, complications and the grade of doctor performing the scan. A consultant radiologist reviewed the scan pictures to confirm that the anatomy was correctly identified.

Results Fifty out of 52 images (96%) were of diagnostic quality, with the anatomy correctly identified. The complication rate from chest drain insertion was 3.85%.

Conclusions With instruction, junior doctors can competently utilise basic chest ultrasound, obtain useful images, identify relevant thoracic anatomy and insert chest drains by the Seldinger technique with a low rate of complications. We suggest thoracic ultrasound should be more widely taught to junior doctors.

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