Can emergency medicine residents detect acute deep venous thrombosis with a limited, two-site ultrasound examination?
The purpose of this prospective clinical study was to determine the ability of Emergency Medicine (EM) residents to accurately detect acute deep venous thrombosis (aDVT) after training in a limited, two-site examination. Six residents received a 90-min session consisting of a lecture and a hands-on component. Each resident then performed the examination on symptomatic extremities referred to the vascular laboratory of a community teaching hospital. The examination was limited to the femoral and popliteal sites and was considered normal when the vein completely compressed. A formal examination was completed by the vascular technician (who was blinded to the resident's results) within 30 min of the resident examination. Of the 121 symptomatic extremities, vascular technicians detected nine cases of aDVT in the target area (7% prevalence); resident examinations revealed eight of these (sensitivity 89%). EM residents can perform a limited duplex examination with considerable but not perfect accuracy after receiving very limited instruction.
Jacoby
Jeanne
J
Emergency Medicine Residency Program, St. Luke's Hospital, Bethlehem, Pennsylvania 18015, USA.
Cesta
Mark
M
Axelband
Jennifer
J
Melanson
Scott
S
Heller
Michael
M
Reed
James
J
D002983:Clinical Competence; D004636:Emergency Service, Hospital; D005268:Femoral Vein / Q000000981:diagnostic imaging; D006801:Humans; D007318:Inservice Training / Q000379:methods*; D007396:Internship and Residency; D011152:Popliteal Vein / Q000000981:diagnostic imaging; D011446:Prospective Studies; D012501:Saphenous Vein / Q000000981:diagnostic imaging; D012680:Sensitivity and Specificity; D014463:Ultrasonography / Q000379:methods* / Q000592:standards; D020246:Venous Thrombosis / Q000000981:diagnostic imaging*