14 Jul Teaching Ultrasound Guidance Of The Hematoma Block Using A High-Fidelity Model
Matthew Kessel, DO.
Department of Emergency Medicine, New York Presbyterian-Brooklyn Methodist Hospital, Brooklyn, New York
Distal radius fractures make up 8%-15% of all bony injuries in adults and account for up to 20% of all fractures treated in the emergency department.
Hematoma block is a frequently utilized modality of anesthesia in cases where reduction is deemed necessary.
Ultrasound guidance may be a useful adjunct in performing the procedure with adequate results, however most physicians tend to perform the procedure blindly. One reason may be inadequate experience or confidence in identifying bony ultrasonographic landmarks.
This study aims to create a low-cost high-fidelity gel-based model to assess operator proficiency in learning the ultrasound-guided hematoma block.
This method also favors students to become more confident in adopting the new tool
Emergency medicine residents will receive a pre-intervention confidence survey on performing ultrasound-guided hematoma blocks.
They will then undergo a training session using a lecture followed by hands-on learning using a gel-based model made to simulate distal radius fracture. After this, there will be an objective structured clinical examination (OSCE) to assess proficiency.
The OSCE will be run by physicians with formal ultrasound training and will grade participants based on technique displayed using the model.
Participants will also complete a post-intervention survey.
The study can be predicted to demonstrate that emergency medicine residents may have increased skill and confidence in the execution of ultrasound-guided hematoma blocks for distal radius fractures using a gel-based model.
Using a high-fidelity gel-based model for training residents in ultrasound-guided hematoma blocks may increase proficiency and confidence in performing the procedure in actual
|1.||Evaluating the Hematoma Block as an Adjunct to Procedural Sedation for Closed Reduction of Distal Forearm Fractures. Constantine, Erika MD; Tsze, Daniel S. MD, MPH; Machan, Jason T. PhD; Eberson, Craig P. MD; Linakis, James G. MD, PhD; Steele, Dale W. MD, MS. Pediatric Emergency Care. 30(7):474-478, 2014.|
|2.||Use of Combined Transmucosal Fentanyl, Nitrous Oxide, and Hematoma Block for Fracture Reduction in a Pediatric Emergency Department. Jimenez, Ana MD; Blazquez, Daniel MD; Cruz, Jaime MD; Palacios, Alba MD; Ordonez, Olga MD; Marin, Milagros PhD; Ruiz-Contreras, Jesus PhD. Pediatric Emergency Care. 28(7):676-679, 2012.|
|3.||Hematoma Block Reduces Narcotic Pain Medication After Femoral Elastic Nailing in Children. Herrera, Jose A. MD; Wall, Eric J. MD; Foad, Susan L. MPH. Journal of Pediatric Orthopaedics. 24(3):254-256, May 2004.|
|4.||Hematoma Block for Ankle Fractures: A Safe and Efficacious Technique for Manipulations. lioto, Richard J.; Furia, John P.; Marquardt, John D. Journal of Orthopaedic Trauma. 9(2):113-116, April 1995.|
|5.||Self-administered nitrous oxide and a hematoma block for analgesia in the outpatient reduction of fractures in children. Hennrikus, W L; Shin, A Y; Klingelberger, C E. Journal of Bone & Joint Surgery – American Volume. 77(3):335-339, March 1995.|
|6.||Plasma Lidocaine Levels Following Hematoma Block for Distal Radius Fractures. Meinig, Richard P.; Lynette Lobmeyer, Allen Quick. Journal of Orthopaedic Trauma. 3(3):187-191, September 1989.|
|7.||Randomized Controlled Feasibility Trial of Intranasal Ketamine Compared to Intranasal Fentanyl for Analgesia in Children with Suspected Extremity Fractures.
Reynolds, Stacy L. MD; Bryant, Kathleen K. MD; Studnek, Jonathan R. PhD; Hogg, Melanie; Dunn, Connell; Templin, Megan A. MS; Moore, Charity G. PhD, MSPH; Young, James R. MD; Walker, Katherine Rivera BSN; Runyon, Michael S. MD, MPH. Academic Emergency Medicine. 24(12):1430-1440, Dec 2017.
|8.||The Efficacy of Intra-Articular Injections for Pain Control Following the Closed Reduction and Percutaneous Pinning of Pediatric Supracondylar Humeral Fractures: A Randomized Controlled Trial. Georgopoulos, Gaia MD; Carry, Patrick BA; Pan, Zhaoxing PhD; Chang, Frank MD; Heare, Travis MD; Rhodes, Jason MD; Hotchkiss, Mark BA; Miller, Nancy H. MD; Erickson, Mark MD. Journal of Bone & Joint Surgery – American Volume. 94(18):1633-1642, September 19, 2012.|
|9.||An Evidence-Based Approach To Traumatic Pain Management In The Emergency Department. Tainter, Christopher R. MD, RDMS 1,4; Jain, Ashika MD, RDMS 2,5; Wattana, Monica K. MD 3,5. Emergency Medicine Practice. 14(8):1-26, August 2012.|
|10.||Axillary Block for Analgesia During Manipulation of Forearm Fractures in the Pediatric Emergency Department A Prospective Randomized Comparative Trial.
Kriwanek, Kelly L. MD; Wan, Jim PhD; Beaty, James H. MD; Pershad, Jay MD. Journal of Pediatric Orthopaedics. 26(6):737-740, November/December 2006.
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