Härle P, Bester J, Hillebrand M, Hartung W
Klinik für Rheumatologie und Physikalische Therapie, Katholisches Klinikum Mainz, An der Goldgrube 11, 55131, Mainz, Deutschland.
Z Rheumatol. 2011 Aug;70(6):525-9. doi: 10.1007/s00393-011-0839-x.
Ultrasound is present in almost any practice and hospital clinic today. In clinical practice, puncture of structures, injections of local anesthetics or glucocorticoids are frequently performed. However, unguided puncture into tissue may have deleterious side-effects if the target is not reached or the drug is not injected properly, such as bleeding, traumatization of delicate structures, glucocorticoid-induced tendon rupture and skin necrosis. Coordination of eye, probe and the manipulation hand needs practice before being used on patients.Therefore, we developed an inexpensive, easy to make and effective learning model for ultrasound-guided puncture and injections. We describe how the model is made and how it can be used to efficiently enhance learning success. It was found that a person unskilled in ultrasonography needs about 40-60 coached punctures in order to confidently hit the target.This model has already been used in our medical education program for rheumatologists, internists, surgeons, orthopedic specialists, anesthetists and general practitioners with great success.
如今,超声波几乎在所有医疗机构和医院诊所中都有应用。在临床实践中,经常会进行结构穿刺、局部麻醉剂或糖皮质激素注射等操作。然而,如果未达到目标或药物注射不当,盲目穿刺组织可能会产生有害的副作用,如出血、损伤精细结构、糖皮质激素诱导的肌腱断裂和皮肤坏死。在对患者进行操作之前,眼睛、探头和操作手的协调需要练习。因此,我们开发了一种廉价、易于制作且有效的超声引导穿刺和注射学习模型。我们描述了该模型的制作方法以及如何使用它来有效提高学习成功率。结果发现,超声检查不熟练的人需要大约40 - 60次有指导的穿刺才能自信地命中目标。该模型已经在我们针对风湿病学家、内科医生、外科医生、骨科专家、麻醉师和全科医生的医学教育项目中成功应用。