{"pk":7866,"title":"BE-SAFE: Bedside Sonography for Assessment of the  Fetus in Emergencies: Educational Intervention for  Late-pregnancy Obstetric Ultrasound","subtitle":null,"abstract":"Introduction:\n Late obstetric emergencies are time critical presentations in the emergency department. Evaluation to ensure the safety of mother and child includes rapid assessment of fetal viability, fetal heart rate (FHR), fetal lie, and estimated gestational age (EGA). Point-of-care (POC) obstetric ultrasound (OBUS) offers the advantage of being able to provide all these measurements. We studied the impact of POC OBUS training on emergency physician (EP) confidence, knowledge, and OBUS skill performance on a live model.\nMethods: \nThis is a prospective observational study evaluating an educational intervention we designed, called the BE-SAFE curriculum (BEdside Sonography for the Assessment of the Fetus in Emergencies). Subjects were a convenience sample of EP attendings (N=17) and residents (N=14). Prior to the educational intervention, participants completed a self-assessment survey on their confidence regarding OBUS, and took a pre-test to assess their baseline knowledge of OBUS. They then completed a 3-hour training session consisting of didactic and hands-on education in OBUS.  After training, each subject’s time and accuracy of performance of FHR, EGA, and fetal lie was recorded. Post-intervention knowledge tests and confidence surveys were administered. Results were compared with non-parametric t-tests.\nResults: \nPre- and post-test knowledge assessment scores for previously untrained EPs improved from 65.7% [SD=20.8] to 90% [SD=8.2] (p<0.0007). Self-confidence on a scale of 1-6 improved significantly for identification of FHR, fetal lie, and EGA. After training, the average times for completion of OBUS critical skills were as follows: cardiac activity (9s), FHR (68.6s), fetal lie (28.1s), and EGA (158.1 sec). EGA estimates averaged 28w0d (25w0d-30w6d) for the model’s true gestational age of 27w0d.\nConclusion: \nAfter a focused POC OBUS training intervention, the BE-SAFE educational intervention, EPs can accurately and rapidly use ultrasound to determine FHR, fetal lie, and estimate gestational age in mid-late pregnancy. [West J Emerg Med. 2014;15(6):–0]","language":"en","license":{"name":"Creative Commons Attribution-NonCommercial  4.0","short_name":"CC BY-NC 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNonCommercial — You may not use the material for commercial purposes.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by-nc/4.0"},"keywords":[{"word":"ultrasound"},{"word":"pregnancy"},{"word":"3rd Trimester"},{"word":"Medicine"},{"word":"Emergency Medicine"}],"section":"Education","is_remote":true,"remote_url":"https://escholarship.org/uc/item/7cd1r7w8","frozenauthors":[{"first_name":"Sachita","middle_name":"","last_name":"Shah","name_suffix":"","institution":"University of Washington School of Medicine, Division of Emergency Medicine, Seattle, Washington","department":"None"},{"first_name":"Adeyinka","middle_name":"","last_name":"Adedipe","name_suffix":"","institution":"University of Washington School of Medicine, Division of Emergency Medicine, Seattle, Washington","department":"None"},{"first_name":"Benjamin","middle_name":"","last_name":"Ruffatto","name_suffix":"","institution":"University of Arizona, Department of Emergency Medicine, Tuscon, Arizona","department":"None"},{"first_name":"Brandon","middle_name":"H","last_name":"Backlund","name_suffix":"","institution":"University of Washington School of Medicine, Division of Emergency Medicine, Seattle, Washington","department":"None"},{"first_name":"Dana","middle_name":"","last_name":"Sajed","name_suffix":"","institution":"Harvard Medical School, Massachusetts General Hospital, Boston, Massachusetts","department":"None"},{"first_name":"Kari","middle_name":"","last_name":"Rood","name_suffix":"","institution":"University of Washington School of Medicine, Division of Emergency Medicine, Seattle, Washington","department":"None"},{"first_name":"Rosemarie","middle_name":"","last_name":"Fernandez","name_suffix":"","institution":"University of Washington School of Medicine, Division of Emergency Medicine, Seattle, Washington","department":"None"}],"date_submitted":"2013-06-05T05:58:16Z","date_accepted":"2013-06-05T05:58:16Z","date_published":"2014-08-14T20:50:02Z","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/westjem/article/7866/galley/4577/download/"}]}