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Background and Aims Aspiration of gastric content in patients with a full stomach is a serious complication of anesthesia, associated with high mortality and morbidity. Recent studies demonstrated that fasting status can be assessed accurately by gastric ultrasound. However, there is still a lack of evidence regarding the application of this technique by inexperienced examiners. We aimed to determine the accuracy of gastric ultrasound performed by medical students after a standardized training sequence.
Methods In this prospective, randomized, examiner-blinded study, five medical students performed 80 gastric ultrasound examinations on healthy, normal weight volunteers (ethics committee approval: Project-ID 2022-00795). The study was conducted from July to September 2022 at the University Hospital Basel. Standardized training consisted of blended online training, one lecture and 2h of hands-on-training. Volunteers were randomized in a 1:1 ratio to ‘fasted’ or ‘not fasted’. Sensitivity, specificity, positive and negative predictive values were calculated from the acquired data.
Results Data from 80 individuals were analyzed. All ‘not fasted’ volunteers were correctly identified (sensitivity 1.00, 95% CI: 0.91-1.00). 15 out of 40 ‘fasted’ volunteers were wrongly classified as ‘non-fasted’ (specificity 0.63, 95% CI: 0.46-0.77). Positive predictive value was 0.73 (95% CI: 0.59-0.84) and negative predictive value 1.00 (95% CI: 0.86-1.00).
Conclusions Examiners with limited experience in ultrasound diagnostics may accurately identify a full stomach in normal weight volunteers after a standardized training sequence. However, the detected specificity of 0.63 was low, and more focused training on the ultrasound anatomy of an empty stomach may be needed to rule out gastric content in a clinical scenario.
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