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


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