Focused cardiac ultrasound examination in the emergency and critical care equine patient : training for non-specialist veterinarians and evaluation of proficiency

Abstract

SUPPORTING INFORMATION : DATA S1. Equine focused cardiac ultrasound (eFoCUS): The course. DATA S2. Equine focused cardiac ultrasound (eFoCUS): Practical test—scoring sheet. DATA S3. Representative questions. VIDEO S1. Right-parasternal left ventricular outflow tract view: Thickening of the tricuspid and aortic valves. VIDEO S2. Right-parasternal left ventricular outflow tract view: Enlargement of the pulmonary artery (PA). The diameter of the PA appears larger compared to the diameter of the aorta indicating pulmonary hypertension. VIDEO S3. Right-parasternal short axis view of the left ventricle. Focal hyperechogenic lesion in the septum. VIDEO S4. Right-parasternal short axis view at the level of the aortic valve: Enlargement of the left atrium (LA). LA area: aortic area ratio > 3:1.BACKGROUND : Focused cardiac ultrasound examination (FoCUS) is rapidly emerging for point-of-care cardiac assessment using hand-carried ultrasound (HCU) devices. A specific FoCUS protocol for horses and adequate training guidelines currently are not available. HYPOTHESIS : To gain knowledge about the training necessary to become proficient in performing FoCUS using a HCU device. ANIMALS : Three healthy Warmblood horses were used for practical training of veterinarians and veterinary students in equine focused cardiac ultrasound (eFoCUS). METHODS : Prospective educational study. An eFoCUS protocol and 1-day training course were developed. Pre- and post-course written tests were administered to participants to evaluate proficiency in knowledge of echocardiography and echocardiographic pathology. A post-course practical examination involved performing eFoCUS and storage of representative images. Images were evaluated using an image quality score and compared between participants with some practical experience and participants with no practical experience. RESULTS : Participants' knowledge of echocardiography increased significantly. Recognition of echocardiographic pathology pre-course ranged from 40% to 90% (mean score, 65.7%) and post-course from 85% to 100% (mean score, 92%). Eighteen of 21 participants were proficient in performing eFoCUS with a median image quality score of 79% (range, 42%-95%). Image quality did not differ between participants with some practical experience compared to participants with no experience. CONCLUSIONS AND CLINICAL IMPORTANCE : Veterinarians and veterinary students independent of previous experience can become proficient in performing eFoCUS after completion of a 1-day training course.http://wileyonlinelibrary.com/journal/jvimhj2023Companion Animal Clinical Studie