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急诊医学住院医师培训项目中的超声引导下髂筋膜间隙阻滞模拟训练

Ultrasound-Guided Fascia Iliaca Compartment Block Simulation Training in an Emergency Medicine Residency Program.

作者信息

Kong Bumin, Zabadayev Sophia, Perese Joshua, Panag Ajit, Jafry Zan

机构信息

Emergency Department, Loma Linda University Medical Center, Loma Linda, USA.

出版信息

Cureus. 2024 Jan 16;16(1):e52411. doi: 10.7759/cureus.52411. eCollection 2024 Jan.

DOI:10.7759/cureus.52411
PMID:38371018
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10869949/
Abstract

Introduction Geriatric hip fractures present a difficult challenge in the emergency department (ED) to achieve adequate analgesia. Opioid-sparing ultrasound-guided fascia iliaca compartment blocks (UFIB) have been shown to be both safe and effective in treating pain from hip fractures. In this study, we investigated the teachability of UFIB to emergency medicine (EM) residents using simulation models and also assessed if UFIB training increases its utility in the ED. Methods We created a UFIB model to simulate the procedure in a controlled environment. Sixteen residents from Loma Linda Emergency Medicine Residency participated in a pre-workshop survey and hands-on UFIB workshop. Comfort level in performing UFIB and confidence level in needle finding skills during UFIB were analyzed, plotted, and represented graphically. Results Comfort level in performing UFIB increased by approximately 50% (p < 0.01). Success rates also increased by 460% (p<0.05) after the workshop. However, the UFIB continued to be underutilized as 44% of respondents expressed that there is a "lack of time" to perform UFIB during their shifts. Conclusion A single one-hour workshop increased comfort level in performing UFIB and helped residents successfully achieve better pain control in patients with hip fractures. However, residents continued to refrain from using UFIB because it is too time-consuming.

摘要

引言

老年髋部骨折给急诊科实现充分镇痛带来了艰巨挑战。已证明,保留阿片类药物的超声引导下髂筋膜室阻滞(UFIB)在治疗髋部骨折疼痛方面既安全又有效。在本研究中,我们使用模拟模型研究了UFIB对急诊医学(EM)住院医师的可教授性,并评估了UFIB培训是否会增加其在急诊科的应用。

方法

我们创建了一个UFIB模型,在可控环境中模拟该操作。来自洛马林达急诊医学住院医师培训项目的16名住院医师参加了工作坊前的调查和UFIB实践工作坊。分析、绘制并以图形方式展示了执行UFIB时的舒适度水平以及UFIB过程中寻找穿刺针技能的信心水平。

结果

执行UFIB的舒适度水平提高了约50%(p < 0.01)。工作坊后成功率也提高了460%(p<0.05)。然而,UFIB的使用仍然不足,因为44%的受访者表示在轮班期间“没有时间”进行UFIB操作。

结论

单次一小时的工作坊提高了执行UFIB的舒适度,并帮助住院医师成功地在髋部骨折患者中更好地控制疼痛。然而,住院医师仍然不愿使用UFIB,因为它太耗时。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4e5d/10869949/ad66d95d6e34/cureus-0016-00000052411-i04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4e5d/10869949/91112f16d3d5/cureus-0016-00000052411-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4e5d/10869949/36991d133f92/cureus-0016-00000052411-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4e5d/10869949/8a36d4b56623/cureus-0016-00000052411-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4e5d/10869949/ad66d95d6e34/cureus-0016-00000052411-i04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4e5d/10869949/91112f16d3d5/cureus-0016-00000052411-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4e5d/10869949/36991d133f92/cureus-0016-00000052411-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4e5d/10869949/8a36d4b56623/cureus-0016-00000052411-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4e5d/10869949/ad66d95d6e34/cureus-0016-00000052411-i04.jpg

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