A Cost-Effective, Rapidly Constructed Simulation Model for Ultrasound-Guided Pericardiocentesis Procedural Training

Kalivoda, Eric J.; Sullivan, Ashley; Bunting, Leonard

doi:10.1016/j.jemermed.2018.09.010

Cited by 15 publications

(8 citation statements)

References 17 publications

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“…Similar models have been described as using gelatin, [2] silicone, [3] ballistics gel, [4] wax, [5,6] and tofu. [7] We believe that, for very low-resource environments, this is a highly functional, low-cost phantom using readily available products and low start-up costs.…”

Section: Discussionmentioning

confidence: 99%

Homemade Cardiac and Vein Cannulation Ultrasound Phantoms for Trauma Management Training in Resource-Limited Settings

et al. 2021

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Ultrasound has become an essential skill for trauma management in resource-limited areas. Prohibitive costs of commercial ultrasound phantoms limit the abilities of many hospitals to adequately train health-care providers. We assessed the utility of homemade phantoms in a wartime setting. Thirty physicians and technicians enrolled in a medical training course, sponsored by the Syrian American Medical Society (SAMS). Ultrasound simulation models were created onsite by using psyllium, gelatin, a hotel coffee maker, and Pyrex dishes. Lamb hearts were used to teach visual diagnosis and subsequent drainage of pericardial effusions. Penrose drains were used to teach vein identification and cannulation under dynamic ultrasound guidance. Two phantoms with a total of 14 penrose drains were created, serving 30 health-care providers. Feedback from participants was positive and within one month of the course, two cases of pericardial tamponade were diagnosed and surgically treated in the largest trauma hospital operated by SAMS. Context : In resource-limited environments, ultrasound phantoms (models) are cost-prohibitive. Aims : We assessed the utility of homemade phantoms in a resource-limited wartime setting to train Syrian physicians and technicians in vein cannulation and limited cardiac ultrasonography. Settings and Design : Thirty physicians and technicians enrolled in a medical training course, sponsored by SAMS. Methods : Ultrasound simulation models were created onsite by using psyllium, gelatin, a hotel coffee maker, and Pyrex dishes. Lamb hearts were used to teach visual diagnosis and subsequent drainage of pericardial effusions. Penrose drains were used to teach vein identification and cannulation under dynamic ultrasound guidance. Two phantoms with a total of 14 penrose drains were created, serving 30 health-care providers. Statistical Analysis Used : N/A Results : Feedback from participants was positive and within one month of the course, two cases of pericardial tamponade were diagnosed and surgically treated in the largest trauma hospital operated by SAMS. Conclusions : Homemade ultrasound phantoms are a promising cost-effective means for meeting an educational gap in ultrasound training, particularly for resource-limited hospitals and possibly more broadly in residency education.

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Section: Discussionmentioning

confidence: 99%

Homemade Cardiac and Vein Cannulation Ultrasound Phantoms for Trauma Management Training in Resource-Limited Settings

et al. 2021

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“…7,8 Due to the need for proper training and the expense of high fidelity, a plethora of low-fidelity and home-made models have been made available. [9][10][11][12][13][14][15] These models have also addressed common practical limitations such as using non-resin medium for ultrasonography and replaceable components. However, to the best of our knowledge, there are no low-fidelity models employing non-animal rib models.…”

Section: Discussionmentioning

confidence: 99%

“…Our model was designed to make small advances on prior low-and high-fidelity models. [9][10][11][12][13][14][15] Our model has a remarkably simple rendering, and it is easy to assemble and replace components after multiple attempts. Using a durable 3D-printed anatomical chest model means we do not need to purchase animal parts or create resin molds; nor does the model degrade.…”

Section: Discussionmentioning

confidence: 99%

A Novel, Low-cost, Low-fidelity Pericardiocentesis Teaching Model

Lord

Lord²,

Geary

2021

WestJEM

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Introduction: Pericardiocentesis is a high-risk/low-frequency procedure important to emergency medicine (EM). However, due to case rarity it is not often performed on a patient during residency training. Because the coronavirus disease 2019 pandemic limited cadaver-based practice, we developed a novel, low-cost, low-fidelity pericardiocentesis model using three dimensional-printing technology to provide advances on prior home-made models. Methods: Residents watched a 20-minute video about performing a pericardiocentesis and practiced both a blind and ultrasound-guided technique. We assessed model fidelity, convenience, and perceived provider competence via post-workshop questionnaire. Results: A total of 24/26 (93%) individuals practicing on the ultrasound-guided model and 22/24 (92%) on the blind approach model agreed or strongly agreed that the models reasonably mimicked a pericardial effusion. Conclusion: Our low-cost, low-fidelity model is durable, mimics the clinical case, and is easy to use. It also addresses known limitations from prior low-fidelity models.

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“…An added bonus is creating a durable model that can be reused without substantial deterioration. Models described in the literature have used items such as pork ribs, 5 tofu, 6 gelatin, 7 or gel wax 8 to serve as the thoracic cavity medium and items such as golf balls, 7 balloons, 8 or ping pong balls 9 to serve as the heart and pericardium. Additionally, some authors took an innovative approach by using chest wall molds to create more realistic models and enhance the experience 10 .…”

mentioning

confidence: 99%

“…Additionally, some authors took an innovative approach by using chest wall molds to create more realistic models and enhance the experience 10 . Overall, do‐it‐yourself models described in the literature are relatively inexpensive, ranging from $1.81 11 to $195 9 . Although many variations of pericardiocentesis simulation models exist in the literature, we sought to combine various aspects of these models with additional novel designs to create a low‐cost, easily constructible, realistic, and reusable model that can be used at any training institution.…”

mentioning

confidence: 99%

A Novel, Reusable, Ultrasound‐Guided Pericardiocentesis Simulation Model

Pezeshki

Boodaie

Kessel

et al. 2020

J of Ultrasound Medicine

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Given the rarity of emergency pericardiocentesis, deliberate effort must be made by the physician to maintain competence in performing this procedure. Herein we describe the construction of a low-cost, reusable, high-fidelity simulation model for ultrasound-guided pericardiocentesis. Sixteen emergency medicine residents participated in a procedure lab using the model and then evaluated the model's efficacy using a survey. Results of this survey found that most participants believed that the model was easy to use and that it increased their competency. There was also a significant increase in self-reported Likert-rated confidence in performing pericardiocentesis before and after simulation (1.63 to 3.81; P < .001).

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A Cost-Effective, Rapidly Constructed Simulation Model for Ultrasound-Guided Pericardiocentesis Procedural Training

Cited by 15 publications

References 17 publications

Homemade Cardiac and Vein Cannulation Ultrasound Phantoms for Trauma Management Training in Resource-Limited Settings

Homemade Cardiac and Vein Cannulation Ultrasound Phantoms for Trauma Management Training in Resource-Limited Settings

A Novel, Low-cost, Low-fidelity Pericardiocentesis Teaching Model

A Novel, Reusable, Ultrasound‐Guided Pericardiocentesis Simulation Model

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