A model for teaching bedside detection of glass in wounds.
BACKGROUND
Emergency physicians often manage wounds contaminated with glass. Even when glass is visible on x rays, removal may require real-time bedside imaging.


OBJECTIVE
To assess whether novices can be easily trained to accurately detect tiny glass foreign bodies (GFBs) using low-power portable fluoroscopy.


METHODS
21 medical students with no prior experience using fluoroscopy were taught to detect 1 mm GFBs in chicken legs either by training over three separate days or by training on 1 day. Skills were reassessed at 3 months. The number of mean correct responses was compared between groups using analysis of variance (ANOVA) and by examination of 95% CIs.


RESULTS
Examination of CI overlap and ANOVA suggested that asymptotic accuracy was achieved after 15-30 training specimens. The final accuracy was similar between protocols, was comparable to prior accuracy reports of plain film radiography and was maintained in both protocols at the 3 month follow-up: 10.9 (0.3) and 12.0 (0.8; out of 15).


CONCLUSIONS
Novices can easily be taught to detect GFBs using fluoroscopy, with accuracy comparable to that achieved by radiologists using plain films. Further studies are needed to assess doctors' use of the technique in real patients.
Levine
Matthew R
MR
Department of Emergency Medicine, Northwestern University, Feinberg School of Medicine, 259 East Erie Street, Suite 100, Chicago, IL 60611, USA. mrlevine@comcast.net
Gorman
Stephen M
SM
Yarnold
Paul R
PR
D000818:Animals; D001291:Attitude of Health Personnel; D002645:Chickens; D004195:Disease Models, Animal; D004521:Educational Measurement; D004635:Emergency Medicine / Q000193:education*; D005471:Fluoroscopy / Q000379:methods; D005547:Foreign Bodies / Q000000981:diagnostic imaging*; D005898:Glass; D006801:Humans; D019095:Point-of-Care Systems; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D014950:Wounds, Penetrating / Q000000981:diagnostic imaging*