Translation of training to practice – ultrasound guided nerve block for analgesia in patients with hip fracture

Gan, Szemein; Tan, Xiang Yin; Kaliannan, Sathya; Chia, Wen Jie Dennis; Chan, Kim Chai; Pek, Jen Heng

doi:10.11152/mu-3537

Cited by 3 publications

(1 citation statement)

References 14 publications

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“…Teaching USGRA traditionally includes didactics and a simulation-based model, followed by supervised performance on living patients, but it is unclear if this approach translates well to USGRA use in patient care [9]. Cadaver patients offer trainees an additional stepping stone to learn USGRA before performing blocks on a living patient.…”

Section: Discussionmentioning

confidence: 99%

Exploring a Cadaver-Based Model for Teaching Emergency Medicine Residents Ultrasound-Guided Serratus Anterior Plane Blocks

Wubben,

Wallum,

Wittrock

2023

Cureus

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BackgroundUltrasound-guided regional anesthesia (USGRA) is increasingly being incorporated into ED clinical practice to provide pain control for a variety of traumatic injuries. The serratus anterior plane block (SAPB) has been shown to be effective at reducing intravenous opioid use and improving pulmonary function for patients with rib fractures, but there is limited prior research about how to safely teach this procedure to emergency medicine (EM) residents. Our goal was to examine the effect of a cadaver-based education model on EM residents' confidence in performing USGRA and provide a review of commonly encountered errors. MethodsEM residents participated in a half-day cadaver-based education session that included a variety of lesscommonly performed procedures including SAPB and fascia iliaca compartment block (FICB) USGRA. Residents received a didactic lecture and hands-on simulation practice during the month prior to the session. During the session, residents performed a SAPB and FICB on the cadaver patient using the same nerve block kit and ultrasound machine they would use for a living patient, with 1:1 supervision by an emergency ultrasound fellowship-trained physician who provided real-time feedback during the procedure. Representative ultrasound video clips were saved and reviewed. Surveys that were completed by residents after the session were analyzed. ResultsThere were 23 residents who participated, and most had not performed any FICB (74%) or SAPB (87%) previously. The percentage of residents comfortable with general USGRA increased from 8.7% to 91.3% (p<0.001). Comfort with FICB increased from 9.1% to 77.3% (p<0.001), and comfort with SAPB increased from 9.1% to 77.3% (p<0.001). Instructors identified and corrected several common errors, such as overly aggressive needle insertion, instillation of air, and instillation of anesthetic into muscle rather than the fascial plane. ConclusionWe found that a cadaver-based education model for teaching EM residents the SAPB and the FICB was associated with significant increases in resident confidence in performing the procedure and facilitated identification and correction of common procedural errors that may otherwise have gone undetected.

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Section: Discussionmentioning

confidence: 99%

Exploring a Cadaver-Based Model for Teaching Emergency Medicine Residents Ultrasound-Guided Serratus Anterior Plane Blocks

Wubben,

Wallum,

Wittrock

2023

Cureus

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Spaceflight-associated pain

Nelson,

Lacinski,

Steller

2024

Current Opinion in Anaesthesiology

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Purpose of review Consequences of the expanding commercial spaceflight industry include an increase in total number of spaceflight participants and an accompanying surge in the average number of medical comorbidities compared with government-based astronaut corps. A sequela of these developments is an anticipated rise in acute and chronic pain concerns associated with spaceflight. This review will summarize diagnostic and therapeutic areas of interest that can support the comfort of humans in spaceflight. Recent findings Painful conditions that occur in space may be due to exposure to numerous stressors such as acceleration and vibration during launch, trauma associated with extravehicular activities, and morbidity resulting directly from weightlessness. Without normal gravitational forces and biomechanical stress, the hostile environment of space causes muscle atrophy, bone demineralization, joint stiffness, and spinal disc dysfunction, resulting in a myriad of pain generators. Repeated insults from abnormal environmental exposures are thought to contribute to the development of painful musculoskeletal and neuropathic conditions. Summary As humanity invests in Lunar and Martian exploration, understanding the painful conditions that will impede crew productivity and mission outcomes is critical. Preexisting pain and new-onset acute or chronic pain resulting from spaceflight will require countermeasures and treatments to mitigate long-term health effects.

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A sequential four-step method facilitates identifying a target nerve or site in ultrasound-guided regional block

BU,

XU,

WANG

2023

Minerva Anestesiol

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Translation of training to practice – ultrasound guided nerve block for analgesia in patients with hip fracture

Cited by 3 publications

References 14 publications

Exploring a Cadaver-Based Model for Teaching Emergency Medicine Residents Ultrasound-Guided Serratus Anterior Plane Blocks

Exploring a Cadaver-Based Model for Teaching Emergency Medicine Residents Ultrasound-Guided Serratus Anterior Plane Blocks

Spaceflight-associated pain

A sequential four-step method facilitates identifying a target nerve or site in ultrasound-guided regional block

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