Department of Emergency Medicine, Gaziantep University Faculty of Medicine, Gaziantep-Türkiye.
Department of General Surgery, Beaumont Health, Royal Oak, MI-USA.
Ulus Travma Acil Cerrahi Derg. 2022 Sep;28(9):1312-1316. doi: 10.14744/tjtes.2022.74712.
Ultrasound-guided vein cannulation is an essential skill in emergency medicine. Prohibitive costs of commercial ultrasound phantoms limit the ability to adequately train residents. We assess the clinical utility of homemade phantoms for medical education.
Eighteen emergency medicine residents each performed 10 ultrasound-guided IV attempts on patients, half of the attempts before and half after a training course using two homemade ultrasound phantoms with 14 total Penrose drains. We conducted a prospective feasibility study using pre- and post-training surveys comparing confidence and success rates of IV cannulation attempts on patients.
Residents demonstrated an improvement in successful ultrasound-guided peripheral vein cannulations from an average of 47.8% during the first five attempts to 71.1% in the last five attempts. No benefit was noted from the first to the fifth attempts, nor from the six to the tenth attempts, suggesting minimal benefit from experience early on. Residents reported increased confidence in performing ultrasound-guided venous cannulation on patients, identifying the correct probe, adjusting gain and depth, visualizing veins in short and long axis, differentiating arteries from veins, and vein cannulation on a phantom model.
Homemade ultrasound phantoms are cost effective, increase confidence, and improve emergency medicine residents' ability to perform ultrasound-guided vein cannulation.
超声引导下静脉穿刺是急诊医学的一项基本技能。商业超声模型的高昂成本限制了对住院医师进行充分培训的能力。我们评估了自制模型在医学教育中的临床应用价值。
18 名急诊医学住院医师对患者进行了 10 次超声引导下 IV 尝试，其中一半在使用两个带有 14 个总彭罗斯引流管的自制超声模型的培训课程前后进行。我们进行了一项前瞻性可行性研究，通过培训前后的调查比较了住院医师在患者身上进行 IV 穿刺尝试的信心和成功率。
住院医师在最初的五次尝试中，成功进行超声引导下外周静脉穿刺的平均成功率从 47.8%提高到了最后五次尝试中的 71.1%。从第一次到第五次尝试，以及从第六次到第十次尝试，均未观察到明显的效果，这表明经验的早期积累带来的益处有限。住院医师报告称，在患者身上进行超声引导下静脉穿刺的信心有所增强，能够正确识别探头，调整增益和深度，在短轴和长轴上观察静脉，区分动脉和静脉，以及在模型上进行静脉穿刺。
自制超声模型具有成本效益，可增强信心，并提高急诊医学住院医师进行超声引导下静脉穿刺的能力。
