254 - FAST Exam Education for Pediatric Residents in the Pediatric Emergency Department

Poster Number: 254
Publication Number: 254.330

Amjad Halloum, Icahn School of Medicine at Mount Sinai, Queens, NY, United States; Chou Jui Lin, Icahn School of Medicine at Mount Sinai, New York, NY, United States; Alice Shajan, Icahn School of Medicine at Mount Sinai/Elmhurst Hospital Center, Long Island City, NY, United States; Rawan Nahas, Mount Sinai, Queens, NY, United States; Smrithi Krishnamohan, Icahn School of Medicine at Mount Sinai - Elmhurst, Queens, NY, United States

Background: The use of Point-of-care ultrasound (POCUS) has been increasing in many medical aspects in recent years. One of its applications is the focused assessment with sonography for trauma (FAST) exam, which is used in patients presenting with trauma to detect intra-abdominal bleeding. In contrast to CT scan, it is readily available and can be done at the bedside without the risk of radiation exposure. Pediatric residents do not routinely receive POCUS training.

Objective: We aim to improve our pediatric residents’ knowledge and confidence level in performing the FAST exam.

Design/Methods: In this ongoing project, each month we recruit residents who are on a 4-week ED rotation to the project, and each completes a confidence and knowledge pretest prior to the rotation. At the start of the rotation, the residents receive a teaching session with a PowerPoint presentation on the FAST exam and a practical training session. The residents are then asked to perform 5-10 FAST scans during the 4-week rotation, with the initial 5 scans under supervision. The scans are performed on patients presenting with trauma, as well as any patient with abdominal pain after the guardian’s consent. At the end of the rotation, each resident completes a knowledge post-test as well as a confidence survey on performing the FAST exam. The results of the pre-and post-tests, as well as the confidence surveys, are compared with paired T-tests to assess the residents’ improvements in both knowledge and confidence in the FAST exam.

Results: In the first 4 month period, a total of 11 residents who completed the post-tests and confidence surveys were included in the analysis. Before the training, 7 residents had no experience with the FAST exam, and the other 4 residents had minimal experience (1-4 previous FAST exams). After training and performing the actual FAST exams, the average confidence level increased from a scale of 1.5 to 6.0 (mean difference 4.5, p-value < 0.00001). The post-test scores average increased from 61.3% to 85.5% (mean difference 24.18%, p-value = 0.00051)Conclusion(s): Pediatric residents have little knowledge and experience with FAST exams at baseline. Our project was able to increase the residents’ knowledge and confidence level in performing the FAST exam in a 4-week ED rotation. This project shows that basic POCUS and FAST exam education can be effective in a short amount of time for pediatric residents, and it can in turn improve patient care and workflow in pediatric emergency departments.
Individual confidence scales in performing FAST ultrasound (on a scale from 1 to 10) pre- and post-trainingD4206B3E-3325-4924-BC1C-EE64C9B3F1C3.jpeg
Individual pre- and post- test scores (%)AD192ADB-7CA5-44A4-9595-330C220FF021.jpeg