BACKGROUND: Diagnosing pericardial effusion is critical for optimal patient care. Typically, clinicians use physical examination ? ndings and historical features suggesting pericardial effusion to determine which pati...BACKGROUND: Diagnosing pericardial effusion is critical for optimal patient care. Typically, clinicians use physical examination ? ndings and historical features suggesting pericardial effusion to determine which patients require echocardiography. The diagnostic characteristics of these tools are not well described. The objective of this study is to determine the prevalence of historical features and sensitivity of clinical signs to inform clinicians when to proceed with echocardiogram.METHODS: A retrospective review of point-of-care echocardiograms performed over a two and a half year period in two emergency departments were reviewed for the presence of a pericardial effusion. Patient charts were reviewed and abstracted for presenting symptoms, historical features and clinical findings. The prevalence of presenting symptoms and historical features and the sensitivity of classic physical examination ? ndings associated with pericardial effusion and tamponade were determined.RESULTS: One hundred and fifty-three patients with pericardial effusion were identified. Of these patients, the most common presenting complaint was chest pain and shortness of breath. Patients had no historical features that would suggest pericardial effusion in 37.5% of cases. None of the patients with pericardial effusion or pericardial tamponade had all of the elements of Beck's triad. The sensitivity of Beck's triad was found to be 0(0%–19.4%). The sensitivity for one ? nding of Beck's triad to diagnose pericardial tamponade was 50%(28.0%–72.0%).CONCLUSION: History and physical examination findings perform poorly as tests for the diagnosis of pericardial effusion or pericardial tamponade. Clinicians must liberally evaluate patients suspected of having a pericardial effusion with echocardiography.展开更多
目的本研究旨在探讨BOPPPS联合案例为基础的学习方法(case-based learning,CBL)+教师主导式教学(lecture based learning,LBL)教学模式在心脏查体带教中的应用效果。方法以广东医科大学2020级本科临床医学专业的132名学生为研究对象,采...目的本研究旨在探讨BOPPPS联合案例为基础的学习方法(case-based learning,CBL)+教师主导式教学(lecture based learning,LBL)教学模式在心脏查体带教中的应用效果。方法以广东医科大学2020级本科临床医学专业的132名学生为研究对象,采用随机数字表法分为对照组(65人)和试验组(67人)。试验组男37人,女30人,年龄(22.37±0.91)岁;对照组男35人,女30人,年龄(22.68±0.69)岁。试验组采用BOPPPS联合CBL+LBL教学模式进行教学,而对照组采用传统的CBL+LBL教学法。最后采用问卷形式对教学效果进行评价。采用χ^(2)检验、独立样本t检验。结果试验组学生的满意度高于对照组[98.5%(66/67)比86.2%(56/65)],差异有统计学意义(P<0.05)。自我评价方面,在“是否激发学习兴趣、是否提高对学习重点难点的掌握、是否增强临床操作技能培养、教学组织的合理性及是否提高临床学习的兴趣”5个项目方面,试验组的学生评价均优于对照组(均P<0.05);在“培养临床思维能力、增强解决问题的能力、师生及医患的沟通和表达能力、学习效率及能力的提高、团队合作能力”5个项目方面,两组之间差异均无统计学意义(均P>0.05)。结论与传统CBL+LBL教学法相比,BOPPPS联合CBL+LBL教学模式,不仅可以提高学生的学习效率,激发其学习兴趣、积极性,同时也增强了他们的临床思维和临床操作技能。因此,这种教学模式具有很好的教学效果,值得推广和应用。展开更多
文摘BACKGROUND: Diagnosing pericardial effusion is critical for optimal patient care. Typically, clinicians use physical examination ? ndings and historical features suggesting pericardial effusion to determine which patients require echocardiography. The diagnostic characteristics of these tools are not well described. The objective of this study is to determine the prevalence of historical features and sensitivity of clinical signs to inform clinicians when to proceed with echocardiogram.METHODS: A retrospective review of point-of-care echocardiograms performed over a two and a half year period in two emergency departments were reviewed for the presence of a pericardial effusion. Patient charts were reviewed and abstracted for presenting symptoms, historical features and clinical findings. The prevalence of presenting symptoms and historical features and the sensitivity of classic physical examination ? ndings associated with pericardial effusion and tamponade were determined.RESULTS: One hundred and fifty-three patients with pericardial effusion were identified. Of these patients, the most common presenting complaint was chest pain and shortness of breath. Patients had no historical features that would suggest pericardial effusion in 37.5% of cases. None of the patients with pericardial effusion or pericardial tamponade had all of the elements of Beck's triad. The sensitivity of Beck's triad was found to be 0(0%–19.4%). The sensitivity for one ? nding of Beck's triad to diagnose pericardial tamponade was 50%(28.0%–72.0%).CONCLUSION: History and physical examination findings perform poorly as tests for the diagnosis of pericardial effusion or pericardial tamponade. Clinicians must liberally evaluate patients suspected of having a pericardial effusion with echocardiography.
文摘目的本研究旨在探讨BOPPPS联合案例为基础的学习方法(case-based learning,CBL)+教师主导式教学(lecture based learning,LBL)教学模式在心脏查体带教中的应用效果。方法以广东医科大学2020级本科临床医学专业的132名学生为研究对象,采用随机数字表法分为对照组(65人)和试验组(67人)。试验组男37人,女30人,年龄(22.37±0.91)岁;对照组男35人,女30人,年龄(22.68±0.69)岁。试验组采用BOPPPS联合CBL+LBL教学模式进行教学,而对照组采用传统的CBL+LBL教学法。最后采用问卷形式对教学效果进行评价。采用χ^(2)检验、独立样本t检验。结果试验组学生的满意度高于对照组[98.5%(66/67)比86.2%(56/65)],差异有统计学意义(P<0.05)。自我评价方面,在“是否激发学习兴趣、是否提高对学习重点难点的掌握、是否增强临床操作技能培养、教学组织的合理性及是否提高临床学习的兴趣”5个项目方面,试验组的学生评价均优于对照组(均P<0.05);在“培养临床思维能力、增强解决问题的能力、师生及医患的沟通和表达能力、学习效率及能力的提高、团队合作能力”5个项目方面,两组之间差异均无统计学意义(均P>0.05)。结论与传统CBL+LBL教学法相比,BOPPPS联合CBL+LBL教学模式,不仅可以提高学生的学习效率,激发其学习兴趣、积极性,同时也增强了他们的临床思维和临床操作技能。因此,这种教学模式具有很好的教学效果,值得推广和应用。
