Resident-performed compression ultrasonography for the detection of proximal deep vein thrombosis: fast and accurate.
OBJECTIVE
To assess whether emergency medicine residents (EMRs) could quickly perform accurate compression ultrasonography (CUS) for the detection of proximal lower extremity deep vein thromboses (PLEDVTs) with minimal training.


METHODS
A prospective, observational study using a convenience sample of patients presenting with signs and/or symptoms for PLEDVT. Vascular laboratory and department of radiology studies were considered the criterion standard. CUS of the femoral vessels was performed. Incompressibility or visualized thrombus was considered "positive."


RESULTS
Eight residents with limited ultrasound (US) experience and no prior experience with deep vein thrombosis (DVT) US volunteered to participate in this study, enrolling 72 patients. Their average scan time was 11.7 minutes (95% CI = 9.4 to 14). There were 23 true positives, 4 false positives, 45 true negatives, and 0 false negatives. The test characteristics for PLEDVT gave a sensitivity of 100% (95% CI = 82.2 to 100) and a specificity of 91.8% (95% CI = 79.5 to 97.4).


CONCLUSIONS
Emergency medicine residents with limited US experience were able to quickly perform CUS after minimal training for the detection of PLEDVT in a select group of patients.
Division of Emergency Medicine, Washington University School of Medicine, St. Louis, MO, USA. jangt@msnotes.wustl.edu
Timothy
T
Jang
Martin
M
Docherty
Chandra
C
Aubin
Greg
G
Polites
D002983:Clinical Competence; D003951:Diagnostic Errors; D004521:Educational Measurement; D004635:Emergency Medicine / Q000193:education*; D005260:Female; D006801:Humans; D007396:Internship and Residency; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D013647:Task Performance and Analysis; D014463:Ultrasonography / Q000379:methods; D014481:United States; D020246:Venous Thrombosis / Q000000981:diagnostic imaging*