• Matthew R Levine, Stephen M Gorman, and Paul R Yarnold.
• Department of Emergency Medicine, Northwestern University, Feinberg School of Medicine, 259 East Erie Street, Suite 100, Chicago, IL 60611, USA. mrlevine@comcast.net
• Emerg Med J. 2007 Jun 1; 24 (6): 413-6.

BackgroundEmergency physicians often manage wounds contaminated with glass. Even when glass is visible on x rays, removal may require real-time bedside imaging.AimTo assess whether novices can be easily trained to accurately detect tiny glass foreign bodies (GFBs) using low-power portable fluoroscopy.Methods21 medical students with no prior experience using fluoroscopy were taught to detect 1 mm GFBs in chicken legs either by training over three separate days or by training on 1 day. Skills were reassessed at 3 months. The number of mean correct responses was compared between groups using analysis of variance (ANOVA) and by examination of 95% CIs.ResultsExamination of CI overlap and ANOVA suggested that asymptotic accuracy was achieved after 15-30 training specimens. The final accuracy was similar between protocols, was comparable to prior accuracy reports of plain film radiography and was maintained in both protocols at the 3 month follow-up: 10.9 (0.3) and 12.0 (0.8; out of 15).ConclusionsNovices can easily be taught to detect GFBs using fluoroscopy, with accuracy comparable to that achieved by radiologists using plain films. Further studies are needed to assess doctors' use of the technique in real patients.

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