Ergonomic task analysis of ultrasound-guided femoral nerve block: a pilot study

Ajmal, Muhammad; Power, Susan; Smith, Tim; Shorten, George

doi:10.1016/j.jclinane.2010.06.006

Cited by 17 publications

(13 citation statements)

References 21 publications

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“…The UGRA education literature has provided the indications of the proficient UGRA practitioner (eg, good ergonomics 22 and economy of motion). 24 A review 47 of recent work on checklists 24 remarked that "fewer and faster movements do not guarantee safety of movement," citing Fitts' work 47 on speed-accuracy trade-offs.…”

Section: Discussionmentioning

confidence: 99%

“…9 A formal structured UGRA training program is described as the optimum way to provide "the coexistence of an appropriate patient, trainee, trainer, and environment." 8 Motor Skills [12][13][14][15][16][17][18][19][20][21][22][23][24][25][26] There is an increasing evidence base 14,20 for simulation using low-or high-fidelity models to decrease the time taken to attain proficiency. Discovery learning occurs at a variable rate, 15 but expert formative feedback 12 shortens the learning curve to an average of 10 procedures (with less complex UGRA blocks).…”

Section: Survey Studies 8-11mentioning

confidence: 99%

See 1 more Smart Citation

A Scoping Review of the Evidence for Teaching Ultrasound-Guided Regional Anesthesia

Nix¹,

Margarido

Awad

et al. 2013

Regional Anesthesia and Pain Medicine

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A scoping review was performed to assess published evidence regarding how best to teach ultrasound-guided regional anesthesia (UGRA). The literature search yielded 205 articles, of which 35 met the inclusion criteria. Current literature on the topic can be divided into 3 main themes: the development of motor skills, learning and teaching sonoanatomy, and understanding of the requirements for establishing a UGRA education program and evaluation. We discuss the current status and future direction of research on UGRA training.

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Section: Discussionmentioning

confidence: 99%

Section: Survey Studies 8-11mentioning

confidence: 99%

A Scoping Review of the Evidence for Teaching Ultrasound-Guided Regional Anesthesia

Nix¹,

Margarido

Awad

et al. 2013

Regional Anesthesia and Pain Medicine

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“…Furthermore, the mean number of passes was significantly lower for NGT, falling from 1.6 ± 1.7 (range, [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19] with CU to 1.2 ± 0.8 (range, 1-10) with NGT (t = 3.49; P = 0.0005; Tables 3 and 6). …”

Section: Number Of Passes and Tasks Completion On First Passmentioning

confidence: 99%

“…11 While both of these technologies can improve needle visualization, robotic and needle-mounted devices suffer from low portability and greater bulk, potentially altering needle technique, in particular adversely contributing to operator fatigue, gaze shifting, awkward hand positioning, and nonergonomic trunk and neck angle. 7,10,[12][13][14] Thus, new needle visualization solutions are needed to further improve needle procedure accuracy with minimal disruption in technique.…”

mentioning

confidence: 99%

Ultrasound-Guided Needle Technique Accuracy

Johnson

Peiffer

Halmann

et al. 2017

Regional Anesthesia and Pain Medicine

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Background and ObjectivesUltrasound-guided regional anesthesia facilitates an approach to sensitive targets such as nerve clusters without contact or inadvertent puncture. We compared accuracy of needle placement with a novel passive magnetic ultrasound needle guidance technology (NGT) versus conventional ultrasound (CU) with echogenic needles.MethodsSixteen anesthesiologists and 19 residents performed a series of 16 needle insertion tasks each, 8 using NGT (n = 280) and 8 using CU (n = 280), in high-fidelity porcine phantoms. Tasks were stratified based on aiming to contact (target-contact) or place in close proximity with (target-proximity) targets, needle gauge (no. 18/no. 22), and in-plane (IP) or out-of-plane (OOP) approach. Distance to the target, task completion by aim, number of passes, and number of tasks completed on the first pass were reported.ResultsNeedle guidance technology significantly improved distance, task completion, number of passes, and completion on the first pass compared with CU for both IP and OOP approaches (P ≤ 0.001). Average NGT distance to target was lower by 57.1% overall (n = 560, 1.5 ± 2.4 vs 3.5 ± 3.7 mm), 38.5% IP (n = 140, 1.6 ± 2.6 vs 2.6 ± 2.8 mm), and 68.2% OOP (n = 140, 1.4 ± 2.2 vs 4.4 ± 4.3 mm) (all P ≤ 0.01). Subgroup analyses revealed accuracy gains were largest among target-proximity tasks performed by residents and for OOP approaches. Needle guidance technology improved first-pass completion from 214 (76.4%) per 280 to 249 (88.9%) per 280, a significant improvement of 16.4% (P = 0.001).ConclusionsPassive magnetic NGT can improve accuracy of needle procedures, particularly among OOP procedures requiring close approach to sensitive targets, such as nerve blocks in anesthesiology practice.

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“…Both reviewers were fellowship‐trained experts in ultrasound‐guided regional anesthesia. Quantitative and qualitative data related to performance and ergonomic key actions 7 for each procedure were collected by using a composite tool adapted from previous studies (Table 1) 1 , 13 and global rating scale 14 …”

Section: Methodsmentioning

confidence: 99%

Evaluation of a Standardized Program for Training Practicing Anesthesiologists in Ultrasound‐Guided Regional Anesthesia Skills

Mariano

Harrison

Kim

et al. 2015

J of Ultrasound Medicine

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he development of ultrasound-guided regional anesthesia teaching methods for resident trainees has been previously studied, 1 but programs for anesthesiologists already in practice are limited; in this population, self-teaching remains very common. 2 In 2009, the American and European Societies of Regional Anesthesia and Pain Medicine published joint committee recommendations for training residents and practicing physicians in ultrasound-guided regional anesthesia. 3 For the latter group, "practice pathway" recomEdward R. Mariano, MD, MAS, T. Kyle Harrison, MD, T. Edward Kim, MD, Jack Kan, MD, Cynthia Shum, RN, BSN, MSEd, David M. Gaba, MD, Toni Ganaway, BA, Alex Kou, BS, Ankeet D. Udani, MD, Steven K. Howard, MD Received December 12, 2014, ORIGINAL RESEARCHObjectives-Practicing anesthesiologists have generally not received formal training in ultrasound-guided perineural catheter insertion. We designed this study to determine the efficacy of a standardized teaching program in this population.Methods-Anesthesiologists in practice for 10 years or more were recruited and enrolled to participate in a 1-day program: lectures and live-model ultrasound scanning (morning) and faculty-led iterative practice and mannequin-based simulation (afternoon). Participants were assessed and recorded while performing ultrasound-guided perineural catheter insertion at baseline, at midday (interval), and after the program (final). Videos were scored by 2 blinded reviewers using a composite tool and global rating scale. Participants were surveyed every 3 months for 1 year to report the number of procedures, efficacy of teaching methods, and implementation obstacles.Results-Thirty-two participants were enrolled and completed the program; 31 of 32 (97%) completed the 1-year follow-up. Final scores [median (10th-90th percentiles)] were 21.5 (14.5-28.0) of 30 points compared to 14.0 (9.0-20.0) at interval (P < .001 versus final) and 12.0 (8.5-17.5) at baseline (P < .001 versus final), with no difference between interval and baseline. The global rating scale showed an identical pattern. Twelve of 26 participants without previous experience performed at least 1 perineural catheter insertion after training (P < .001). However, there were no differences in the monthly average number of procedures or complications after the course when compared to baseline.Conclusions-Practicing anesthesiologists without previous training in ultrasoundguided regional anesthesia can acquire perineural catheter insertion skills after a 1-day standardized course, but changing clinical practice remains a challenge.

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Ergonomic task analysis of ultrasound-guided femoral nerve block: a pilot study

Cited by 17 publications

References 21 publications

A Scoping Review of the Evidence for Teaching Ultrasound-Guided Regional Anesthesia

A Scoping Review of the Evidence for Teaching Ultrasound-Guided Regional Anesthesia

Ultrasound-Guided Needle Technique Accuracy

Evaluation of a Standardized Program for Training Practicing Anesthesiologists in Ultrasound‐Guided Regional Anesthesia Skills

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