{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,29]],"date-time":"2026-03-29T11:23:18Z","timestamp":1774783398777,"version":"3.50.1"},"reference-count":16,"publisher":"Cambridge University Press (CUP)","issue":"6","license":[{"start":{"date-parts":[[2025,11,27]],"date-time":"2025-11-27T00:00:00Z","timestamp":1764201600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Prehosp. Disaster med."],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec id=\"S1049023X25101520_as1\">\n                    <jats:title>Introduction:<\/jats:title>\n                    <jats:p>Echocardiography is the preferred method for the visual assessment of bubble load in divers. This study evaluates the feasibility of a microteaching program for training combat medics to perform ultrasound measurements using echocardiography for self-monitoring decompression stress on the waterside.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S1049023X25101520_as2\">\n                    <jats:title>Materials and Method:<\/jats:title>\n                    <jats:p>A microteaching was provided to combat medics of the Netherlands Armed Forces. Participants used a handheld ultrasound device connected to a tablet. After two minutes practice time, medics performed and recorded videos on randomly assigned partners while being assessed by an anesthesiologist. Three outcomes were measured: (1) observer-assessed performance adapted from Objective Structured Assessment of Technical Skills (OSATS); (2) self-perceived procedure experience; and (3) video recording quality on a five-point scale.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S1049023X25101520_as3\">\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>All 21 combat medics completed the microteaching program. Three out of 21 video recordings were lost due to technical issues. All participants successfully obtained at least a partial cardiac view (median time: 61 seconds). Performance scores indicated near-competence across preparation, time-motion, and procedural flow. Image quality ratings by two reviewers showed near-perfect intra-rater agreement (\u03ba = 0.904 and \u03ba = 0.960) but substantial inter-rater variability (\u03ba = 0.671); the assessor\u2019s median scores were 2.75 and 3.0 out of 5.0, respectively. Most recordings received average scores of 3.0 or higher.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S1049023X25101520_as4\">\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>This study demonstrates that combat medics, following a brief microteaching session, were able to acquire cardiac ultrasound images partially suitable for assessing vascular gas emboli (VGE). These findings support microteaching as a feasible first step in echocardiography training for combat medics in austere environments.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1017\/s1049023x25101520","type":"journal-article","created":{"date-parts":[[2025,11,27]],"date-time":"2025-11-27T15:32:13Z","timestamp":1764257533000},"page":"313-318","update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":0,"title":["Echocardiography Performed by Combat Medics: A Feasibility Study"],"prefix":"10.1017","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-6606-9788","authenticated-orcid":false,"given":"BL","family":"Turner","sequence":"first","affiliation":[{"name":"Diving Medical Centre"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"JC","family":"van de Voort","sequence":"additional","affiliation":[{"name":"Department of Surgery"},{"name":"University Medical Centre Rotterdam"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"BLS","family":"Borger van der Burg","sequence":"additional","affiliation":[{"name":"Department of Surgery"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"CM","family":"Fransen","sequence":"additional","affiliation":[{"name":"Ministry of Defense"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"CMH","family":"Obbink","sequence":"additional","affiliation":[{"name":"Haaglanden Medisch Centrum"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"RP","family":"Weenink","sequence":"additional","affiliation":[{"name":"Ministry of Defense"},{"name":"University of Amsterdam"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R","family":"Hoencamp","sequence":"additional","affiliation":[{"name":"Diving Medical Centre"},{"name":"Department of Surgery"},{"name":"University Medical Centre Rotterdam"},{"name":"Ministry of Defense"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"56","published-online":{"date-parts":[[2025,11,27]]},"reference":[{"key":"S1049023X25101520_ref12","doi-asserted-by":"publisher","DOI":"10.1093\/milmed\/usac207"},{"key":"S1049023X25101520_ref10","doi-asserted-by":"publisher","DOI":"10.1097\/MEJ.0000000000000246"},{"key":"S1049023X25101520_ref15","doi-asserted-by":"publisher","DOI":"10.5847\/wjem.j.1920-8642.2022.017"},{"key":"S1049023X25101520_ref3","first-page":"68","article-title":"Use of ultrasound in decompression research","volume":"37","author":"Pollock","year":"2007","journal-title":"Diving and Hyperbaric Medicine."},{"key":"S1049023X25101520_ref5","first-page":"99","article-title":"The relationship between venous gas bubbles and adverse effects of decompression after air dives","volume":"34","author":"Eftedal","year":"2007","journal-title":"Undersea Hyperb Med."},{"key":"S1049023X25101520_ref2","first-page":"531","article-title":"Decompression models: review, relevance, and validation capabilities","volume":"41","author":"Hugon","year":"2014","journal-title":"Undersea Hyperb Med."},{"key":"S1049023X25101520_ref13","doi-asserted-by":"publisher","DOI":"10.1111\/echo.15939"},{"key":"S1049023X25101520_ref4","doi-asserted-by":"publisher","DOI":"10.22462\/01.03.2021.8"},{"key":"S1049023X25101520_ref7","doi-asserted-by":"publisher","DOI":"10.1007\/s11739-021-02802-z"},{"key":"S1049023X25101520_ref8","doi-asserted-by":"publisher","DOI":"10.1007\/s00595-012-0313-7"},{"key":"S1049023X25101520_ref9","doi-asserted-by":"publisher","DOI":"10.1007\/s00421-018-3854-7"},{"key":"S1049023X25101520_ref6","first-page":"5","article-title":"The use of portable 2D echocardiography and \u201cframe-based\u201d bubble counting as a tool to evaluate diving decompression stress","volume":"44","author":"Germonpr\u00e9","year":"2014","journal-title":"Diving Hyperb Med."},{"key":"S1049023X25101520_ref11","doi-asserted-by":"publisher","DOI":"10.55460\/ETP1-7VPU"},{"key":"S1049023X25101520_ref1","unstructured":"1. Lambert, A. The future of underwater warfare. Council on Geostrategy. https:\/\/www.geostrategy.org.uk\/britains-world\/the-future-of-underwater-warfare\/?utm_source=chatgpt.com. Accessed April 30, 2025."},{"key":"S1049023X25101520_ref14","first-page":"26","article-title":"Consensus guidelines for the use of ultrasound for diving research","volume":"46","author":"M\u00f8llerl\u00f8kken","year":"2016","journal-title":"Diving Hyperb Med."},{"key":"S1049023X25101520_ref16","doi-asserted-by":"publisher","DOI":"10.3389\/fphys.2022.907651"}],"container-title":["Prehospital and Disaster Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S1049023X25101520","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,29]],"date-time":"2026-03-29T07:39:19Z","timestamp":1774769959000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S1049023X25101520\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11,27]]},"references-count":16,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2025,12]]}},"alternative-id":["S1049023X25101520"],"URL":"https:\/\/doi.org\/10.1017\/s1049023x25101520","relation":{},"ISSN":["1049-023X","1945-1938"],"issn-type":[{"value":"1049-023X","type":"print"},{"value":"1945-1938","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,11,27]]},"assertion":[{"value":"\u00a9 The Author(s), 2025. Published by Cambridge University Press on behalf of World Association for Disaster and Emergency Medicine","name":"copyright","label":"Copyright","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}}]}}