Clinical trial NCT03827421: Junior Emergency Physician Learning Curve to Perform Transcranial Doppler on Brain-damage Patients
Official title: Transcranius : Junior Emergency Physician Learning Curve to Perform Transcranial Doppler on Brain-damage Patients
Study type: OBSERVATIONAL
Overall status: TERMINATED
Conditions: Brain Damage
Keywords: transcranial doppler
learning curve
emergency
traumatic brain injury
Lead sponsor: University Hospital, Grenoble
Sponsor class: OTHER
First posted: 2019-02-01
Enrollment: 33
Sex: ALL
Minimum age (years): 18
Maximum age (years): 100
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Observational model: OTHER
Time perspective: PROSPECTIVE
Sampling method: NON_PROBABILITY_SAMPLE
Study population: Brain-damaged patients hospitalized in neurosurgical resuscitation or intensive care unit.

Brief summary: Transcranial Doppler is a noninvasive tool. Using velocity measurements and pulsatility index it allows the evaluation of cerebral haemodynamics. In patients presenting brain injury cerebral perfusion may be impaired. Indirect cerebral blood flow can be monitored and risk of neurological worsening can be detected using transcranial Doppler. Education and performance of emergency physicians must be evaluated on brain-injured patients because this tool is operator dependent. The main objective of this study is to estimate the average number of exams required to learn transcranial Doppler within junior emergency physicians with the achievement of their learning curve. We will perform a prospective, monocentric, observational study within the neurosurgical resuscitation department of Grenoble Alpes University Hospital.

Detailed description: The transcranial dopplers will be carry out on 75 brain-damaged patients by 13 emergency residents physicians after a theoretical and practical training. They will be evaluated by 8 experts. The primary endpoint will be the mean number of transcranial dopplers required to have an excellent concordance between resident and expert. The concordance between the Doppler findings of the resident and the expert would exceed 0.8 before 30 examinations. The learning curve assessed on the duration necessary to acquire good quality data should decrease rapidly with the repetition of the examinations. Validating the transcranial Doppler learning curve for junior emergency physician would allow them to perform this exam safely and efficiently. Transcranial Doppler may be easy and fast to learn but the persistence of its competency over time should be evaluated.

Eligibility criteria: Inclusion Criteria:

* Adult patients : ≥ 18 year and older
* Hospitalized in the neurosurgical resuscitation or intensive care unit
* Brain - damaged patients

Exclusion Criteria:

* Any craniotemporal lesion impeding satisfactory TDC examination : no transtemporal doppler window, patient with craniectomy.
* Patient with meningo-encephalitis
* Patient with cerebral vasculitis
* Patient without health insurance coverage
* Patient subject to a legal protection measure
* Pregnant woman , parturient or nursing

Primary outcomes:
measure: The mean number of transcranial doppler required to reach a kappa over 0,8 between the conclusions of the resident and expert.
timeFrame: 3 months
Secondary outcomes:
measure: Duration in seconds for the junior to achieve the transcranial doppler
timeFrame: 3 months
measure: Analysis of the spectral envelope quality
timeFrame: 3 months
measure: Analysis of the evolution of the estimated difficulty of transcranial doppler realization
timeFrame: 3 months
measure: Analysis of the failure to perform the transcranial doppler
timeFrame: 10 minutes
measure: Analysis of the diastolic velocities and pulsatility index concordance between junior and expert
timeFrame: 3 months
Other outcomes:
Locations:
city: Grenoble
country: France
facility: University Hospital Grenoble
state: Auvergne Rhonalpes
Study officials:
affiliation: University Hospital, Grenoble
name: Batistin MARTINON, MD
role: PRINCIPAL_INVESTIGATOR
References: