Celi Julien, Fehlmann Christophe A, Rutschmann Olivier T, Pelieu-Lamps Iris, Fournier Roxane, Nendaz Mathieu, Sarasin François, Rouyer Frédéric
Emergency Unit, Department of Acute Medicine, Geneva University Hospitals, Rue Gabrielle-Perret-Gentil 2, CH-1205, Geneva, Switzerland.
Anesthesiology Unit, Department of Acute Medicine, Geneva University Hospitals, Geneva, Switzerland.
Int J Emerg Med. 2020 Nov 30;13(1):57. doi: 10.1186/s12245-020-00317-6.
Ultrasound-guided fascia iliaca compartment block (US-FICB) is not part of the learning curriculum of the emergency physicians (EP) and is usually performed by anesthesiologists. However, several studies promote EP to use this procedure. The goal of this study was to assess the feasibility of a training concept for non-anesthesiologists for the US-FICB on a simulator based on a validating learning path.
This was a feasibility study. Emergency physicians and medical students received a 1-day training with a learning phase (theoretical and practical skills), followed by an assessment phase. The primary outcome at the assessment phase was the number of attempts before successfully completing the procedure. The secondary outcomes were the success rate at first attempt, the length of procedure (LOP), and the stability of the probe, corresponding to the visualization of the needle tip (and its tracking) throughout the procedure, evaluated on a Likert scale.
A total of 25 participants were included. The median number of attempts was 2.0 for emergency physicians and 2.5 for medical students, and this difference was not significant (p = 0.140). Seven participants (28%) succeeded at the first attempt of the procedure; the difference between emergency physicians and medical students was not significant (37% versus 21%; p = 0.409). The average LOP was 19.7 min with a significant difference between emergency physicians and medical students (p = 0.001). There was no significant difference regarding the stability of the probe between the two groups.
Our 1-day training for non-anesthesiologists with or without previous skills in ultrasound seems to be feasible for learning the US-FICB procedure on a simulator.
超声引导下髂筋膜间隙阻滞(US-FICB)并非急诊医师(EP)学习课程的一部分,通常由麻醉医师实施。然而,多项研究鼓励急诊医师采用这一操作。本研究的目的是基于一条经过验证的学习路径,评估在模拟器上针对非麻醉医师的US-FICB培训概念的可行性。
这是一项可行性研究。急诊医师和医学生接受了为期1天的培训,包括一个学习阶段(理论和实践技能),随后是一个评估阶段。评估阶段的主要结果是成功完成操作前的尝试次数。次要结果是首次尝试的成功率、操作时长(LOP)以及探头的稳定性,通过李克特量表评估整个操作过程中针尖的可视化情况(及其跟踪)。
共纳入25名参与者。急诊医师的尝试次数中位数为2.0次,医学生为2.5次,差异无统计学意义(p = 0.140)。7名参与者(28%)在首次尝试操作时成功;急诊医师和医学生之间的差异无统计学意义(37%对21%;p = 0.409)。平均操作时长为19.7分钟,急诊医师和医学生之间存在显著差异(p = 0.001)。两组之间探头稳定性无显著差异。
我们为有或没有超声技能的非麻醉医师提供的为期1天的培训,似乎对于在模拟器上学习US-FICB操作是可行的。