The Novel US-C-A-B Protocol: Curriculum Implementation and Evaluation of Proficiency

Study Overview
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Brief Summary
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Ultrasound is a frequently used diagnostic tool in the emergency department and suggested to have a role during resuscitation. The aims of this study were to develop a novel, resuscitative ultrasound-circulation-airway-breathing (US-C-A-B) protocol, to implement a short curriculum and to assess the feasibility. The US-C-A-B protocol was built in an advanced life support-compliant manner. It involved a 3-part assessment: (1) C: subxiphoid 4-chamber view of the heart; (2) A: tracheal ultrasound; and (3) B: bilateral lung sliding. It could be used for direct confirmation for the C-A-B and searching the possible cause of cardiac arrest. A half-day curriculum was designed, and comprised of one-hour didactics and 3-hour small-group hand-on training. Assessments were performed, including a written test, the US image acquisition and a satisfaction survey. From August 1, 2014 to March 31, 2016, the multi-center emergency physicians who attended the US-C-A-B curricula were enrolled prospectively.

Detailed Description
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Ultrasound is a frequently used diagnostic tool in the emergency department and suggested to have a role during resuscitation. The aims of this study were to develop a novel, resuscitative ultrasound-circulation-airway-breathing (US-C-A-B) protocol, to implement a short curriculum and to assess the feasibility. The US-C-A-B protocol was built in an advanced life support-compliant manner. It involved a 3-part assessment: (1) C: subxiphoid 4-chamber view of the heart; (2) A: tracheal ultrasound; and (3) B: bilateral lung sliding. It could be used for direct confirmation for the C-A-B and searching the possible cause of

Official Title
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The Novel US-C-A-B Protocol: Curriculum Implementation and Evaluation of Proficiency

Conditions
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Ultrasound Therapy; Complications

Intervention / Treatment
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* Behavioral: ultrasound training


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: The enrolled participants were emergency physicians of the National Taiwan University Hospital (NTUH), the Far-Eastern Memorial Hospital (FEMH) and the Chang-Kung Memorial Hospital (CKMH), three teaching hospitals in Taiwan. Exclusion Criteria: Not emergency physicians.

Ages Eligible for Study
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Minimum Age: 25 Years
Maximum Age: 60 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Other
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Other: ultrasound training<br>The aims were to develop a novel, resuscitative ultrasound-circulation-airway-breathing (US-C-A-B) protocol, to implement a short curriculum for ultrasound training and to assess the feasibility. | Behavioral: ultrasound training<br>* Through the ultrasound-circulation-airway-breathing training curriculum to integrate the ultrasound into clinical practice.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| The time of the US image acquisition | The 6-month evaluation was performed in cardiac arrest patients. The ultrasound operation time was from the time to initiate the ultrasound exam to when the sonographers to inteprete the results, using the ultrasound recorder. | 6 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Learning efficacy was assessed with a written test with 10 multi-choice questions. | The written test with 10 multi-choice questions, including ALS knowledge, and still US image interpretation of C-A-B was performed before and after completion of the course. | through study completion, an average of 1 year | 
| A satisfaction survey with a 5-point Likert scale. | The post-course satisfaction survey queried the participants in regards to educational value, knowledge acquisition and self-confidence at the end of the course. The survey consisted of 5 items, using a 5-point Likert scale. | through study completion, an average of 1 year | 
| The time of the US image acquisition | The participants were asked for to produce adequate views of each C-A-B category and consecutive C-A-B exams in the same live model after completion, recorded by the DVD recorder. The time to achieve the views was measured from positioning of the probe on the skin to maintaining an adequate image for at least 3 seconds. The videos were edited that the faces of the participants were covered, and reviewed blindly and independently by the authors. The 6-month evaluation was performed in cardiac arrest patients. The ultrasound operation time was from the time to initiate the ultrasound exam to when the sonographers to inteprete the results, using the ultrasound recorder. | through study completion, an average of 1 year |