Development of a novel simulation‐based task trainer for management of retrobulbar hematoma

Abstract

Background Retrobulbar hematoma (RH) is a rare but devastating complication of sinus surgery. It is treated initially with a lateral canthotomy and cantholysis at the bedside. Due to the high stakes and urgency of this complication, teaching this in the clinical setting is difficult. The objective of this study was to develop a cadaveric model for addressing this problem. Methods A fresh‐frozen human cadaveric model of RH was created using a Foley catheter to simulate elevated intraocular pressure. Residents who participated in an emergencies in otolaryngology–head & neck surgery “boot camp” were included in the study. A survey measuring confidence levels in performing lateral canthotomy and cantholysis was administered. After completing the skill station, a postintervention survey was administered to assess the confidence of the learner as well as fidelity and usefulness of the task trainer. Results Thirty‐three residents participated in the boot camp. Residents rated their confidence preintervention at 1.3/5, which suggests the majority were unable to perform the procedure. After using the model, residents rated their confidence at 3.5/5, which falls between basic knowledge and reasonably confident; this improvement achieved statistical significance (p < 0.0001). The fidelity of the model was rated 3.9/5; a score of 4 is defined as realistic. The residents rated the usefulness of the model as 4.7; a score of 5 is defined as very useful. Conclusion A cadaveric model of RH was successfully developed. This novel simulator was perceived to be useful, realistic, and effective by junior residents.

Does a Junior Doctor focused ‘Bootcamp’ improve the confidence and preparedness of newly appointed ENT registrars to perform their job roles?

“…This aligns with the prior reported literature of signi cant improvements in trainee self-con dence following their participation in an ENT boot camp. 1,2,8,9,13,[17][18][19][20] Our data demonstrated that ENT ST3s reported the greatest improvements in self-preparedness in the rigid bronchoscopy station and the greatest improvement in self-con dence in the sphenopalatine artery (SPA) ligation station compared to the other stations (Table 3). While SPA ligation has not been reported in an ENT bootcamp setting, the tracheostomy ndings support the literature.…”

“…Our study suggests that ST3 knowledge improved over a two day bootcamp, which along with the literature, provides evidence that knowledge acquisition through bootcamps may help ST3s to transition into their new clinical role more easily. 1,2,8,9,13,[17][18][19][20] Additionally, the inclusion of simulation stations allows ST3s to acquire the technical and non-technical skills expected of ENT ST3's. The literature suggests that bootcamps are a useful adjunct to the traditional apprenticeship training model, as they provide a standardised and equal approach towards the training of ST3's that can integrate the use of performance metrics unlike the variability of clinical exposure.…”

Interdisziplinäre Therapie der Erkrankungen der Orbita

“…Bei Einblutungen nach Trauma oder nach endonasaler Nasennebenhöhlen Operation mit erheblicher Erhöhung des intraorbitalen Druckes kann als Erstmaßnahme mittels einer lateralen Kanthotomie bzw. einer Kantholyse mit transpalpebraler Eröffnung des Septum orbitale eine Reduktion des intraorbitalen Druckes erreicht werden [26,27]. Die Drucksenkung bei einer lateralen Kanthotomie beträgt bis zu 14,2 mmHg, bei einer Kantholyse 30,4 mmHg [28].…”

Retrobulbar haematoma secondary to haemophilia A in a dog

“…3 Reports on orbital haematomas secondary to haemostasis disorders have rarely been described in humans. 4,5 Similarly, in dogs, there is a low number of reported cases of retrobulbar haematomas, some being secondary to anticoagulant rodenticide toxicity 6 and one recent report being associated with von Willebrand disease. 7 A case of retrobulbar haematoma secondary to haemophilia A in a dog is described.…”