Zaia Brita E, Briese Beau, Williams Sarah R, Gharahbaghian Laleh
Department of Surgery, Division of Emergency Medicine, Stanford University Medical Center, Palo Alto, California, USA.
J Emerg Med. 2012 Oct;43(4):683-91. doi: 10.1016/j.jemermed.2012.01.057. Epub 2012 Apr 14.
As the use of bedside emergency ultrasound (US) increases, so does the need for effective US education.
To determine 1) what pathology can be reliably simulated and identified by US in human cadavers, and 2) feasibility of using cadavers to improve the comfort of emergency medicine (EM) residents with specific US applications.
This descriptive, cross-sectional survey study assessed utility of cadaver simulation to train EM residents in diagnostic US. First, the following pathologies were simulated in a cadaver: orbital foreign body (FB), retrobulbar (RB) hematoma, bone fracture, joint effusion, and pleural effusion. Second, we assessed residents' change in comfort level with US after using this cadaver model. Residents were surveyed regarding their comfort level with various US applications. After brief didactic sessions on the study's US applications, participants attempted to identify the simulated pathology using US. A post-lab survey assessed for change in comfort level after the training.
Orbital FB, RB hematoma, bone fracture, joint effusion, and pleural effusion were readily modeled in a cadaver in ways typical of a live patient. Twenty-two residents completed the pre- and post-lab surveys. After training with cadavers, residents' comfort improved significantly for orbital FB and RB hematoma (mean increase 1.6, p<0.001), bone fracture (mean increase 2.12, p<0.001), and joint effusion (1.6, p<0.001); 100% of residents reported that they found US education using cadavers helpful.
Cadavers can simulate orbital FB, RB hematoma, bone fracture, joint effusion, and pleural effusion, and in our center improved the comfort of residents in identifying all but pleural effusion.
随着床旁急诊超声（US）的使用增加，对有效的超声教育的需求也在增加。
确定1）超声在人体尸体中能够可靠模拟和识别哪些病理情况，以及2）使用尸体来提高急诊医学（EM）住院医师对特定超声应用的操作舒适度的可行性。
这项描述性横断面调查研究评估了尸体模拟在培训急诊医学住院医师进行超声诊断方面的效用。首先，在一具尸体中模拟以下病理情况：眼眶异物（FB）、球后（RB）血肿、骨折、关节积液和胸腔积液。其次，我们评估了住院医师在使用这种尸体模型后超声操作舒适度的变化。就各种超声应用的舒适度对住院医师进行了调查。在关于本研究超声应用的简短授课之后，参与者尝试使用超声识别模拟的病理情况。一项实验后调查评估了培训后舒适度的变化。
眼眶FB、RB血肿、骨折、关节积液和胸腔积液能够以活体患者典型的方式在尸体中轻松模拟。22名住院医师完成了实验前和实验后的调查。在尸体培训后，住院医师在眼眶FB和RB血肿（平均增加1.6，p<0.001）、骨折（平均增加2.12，p<0.001）和关节积液（1.6，p<0.001）方面的舒适度显著提高；100%的住院医师报告称他们发现使用尸体进行超声教育很有帮助。
尸体能够模拟眼眶FB、RB血肿、骨折、关节积液和胸腔积液，并且在我们中心提高了住院医师识别除胸腔积液外所有情况的舒适度。
