Literature DB >> 30051027

Challenges and Variations in Emergency Medicine Residency Training of Ultrasound-guided Regional Anesthesia Techniques.

Casey Lee Wilson1, Kevin Chung1, Tiffany Fong1.   

Abstract

BACKGROUND: Ultrasound guidance has become an integral component to procedural and diagnostic practice for the emergency physician. Whereas landmark-guided methods were used for peripheral nerve blocks in the past, the use of ultrasound has made regional anesthesia procedures faster, more successful, and feasible as a pain management modality in the emergency department. Not only the utilization, but also the teaching of ultrasound has become an essential aspect of emergency medicine residency training. Prior studies have found a substantial variation in practice and policies with regard to ultrasound-guided regional anesthesia (UGRA) and this translates to the education of both residents and fellows.
OBJECTIVES: The objective was to describe the current state of UGRA education, trends, and barriers in emergency medicine residency and ultrasound fellowship programs in the United States.
METHODS: A cross-sectional survey was conducted via the Internet utilizing the Qualtrics software platform. It was distributed to ultrasound directors and program directors of both Accreditation Council for Graduate Medical Education (ACGME) and American Osteopathic Association (AOA) accredited emergency medicine residency programs and ultrasound fellowships. Data analysis, cross-tabulation, and subgroup analysis were performed utilizing the software.
RESULTS: We received a total of 138 responses (response rate of 66.3%). There was substantial variability with regard to implementing UGRA education. Additionally, there was a trend correlating a greater likelihood of UGRA education among programs with more than two ultrasound faculty members. Faculty training is considered to be the greatest barrier to teaching UGRA to residents and fellows.
CONCLUSION: Resident and fellow education with regard to UGRA varies significantly among individual programs. Although there are currently no ACGME or AOA guidelines, nearly all residency programs believe that this is a skill that emergency physicians should learn. With the identification of key barriers and the need for an increased number of trained faculty, pain management utilizing UGRA may become an integral part to emergency medicine resident and fellow education.

Entities:  

Year:  2017        PMID: 30051027      PMCID: PMC6001815          DOI: 10.1002/aet2.10014

Source DB:  PubMed          Journal:  AEM Educ Train        ISSN: 2472-5390


  28 in total

1.  CORD-AEUS: consensus document for the emergency ultrasound milestone project.

Authors:  Resa E Lewiss; Michelle Pearl; Jason T Nomura; Gillian Baty; Rimon Bengiamin; Kael Duprey; Michael Stone; Daniel Theodoro; Saadia Akhtar
Journal:  Acad Emerg Med       Date:  2013-07       Impact factor: 3.451

2.  A modified paravertebral block to reduce risk of mortality in a patient with multiple rib fractures.

Authors:  Hitoshi Yoshida; Shinya Yaguchi; Atsufumi Matsumoto; Hiroyuki Hanada; Hidetomo Niwa; Masatou Kitayama
Journal:  Am J Emerg Med       Date:  2014-10-25       Impact factor: 2.469

3.  Ultrasound competency assessment in emergency medicine residency programs.

Authors:  Richard Amini; Srikar Adhikari; Albert Fiorello
Journal:  Acad Emerg Med       Date:  2014-07-08       Impact factor: 3.451

4.  Ultrasound-Guided Nerve Blocks in Emergency Medicine Practice.

Authors:  Richard Amini; Jeffrey Z Kartchner; Arun Nagdev; Srikar Adhikari
Journal:  J Ultrasound Med       Date:  2016-03-01       Impact factor: 2.153

5.  A presurvey and postsurvey of a web- and simulation-based course of ultrasound-guided nerve blocks for pediatric emergency medicine.

Authors:  Adam Bretholz; Quynh Doan; Adam Cheng; Gillian Lauder
Journal:  Pediatr Emerg Care       Date:  2012-06       Impact factor: 1.454

Review 6.  Pediatric nerve blocks: an evidence-based approach.

Authors:  Sacha Duchicela; Anthoney Lim
Journal:  Pediatr Emerg Med Pract       Date:  2013-10

7.  Ultrasound-guided supraclavicular brachial plexus nerve block vs procedural sedation for the treatment of upper extremity emergencies.

Authors:  Michael B Stone; Ralph Wang; Daniel D Price
Journal:  Am J Emerg Med       Date:  2008-07       Impact factor: 2.469

Review 8.  Simulation in teaching regional anesthesia: current perspectives.

Authors:  Ankeet D Udani; T Edward Kim; Steven K Howard; Edward R Mariano
Journal:  Local Reg Anesth       Date:  2015-08-11

9.  A low cost, high fidelity nerve block model.

Authors:  Scott Sparks; David Evans; Don Byars
Journal:  Crit Ultrasound J       Date:  2014-08-13

10.  Ultrasound-guided nerve blocks for intracapsular and extracapsular hip fractures.

Authors:  Eitan Dickman; Illya Pushkar; Antonios Likourezos; Knox Todd; Ula Hwang; Saadia Akhter; Sean Morrison
Journal:  Am J Emerg Med       Date:  2015-12-14       Impact factor: 2.469

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  6 in total

1.  Bringing Ultrasound-guided Regional Anesthesia to Emergency Medicine.

Authors:  Andrew A Herring
Journal:  AEM Educ Train       Date:  2017-03-29

Review 2.  Ultrasound-Guided Peripheral Nerve Blocks: A Practical Review for Acute Cancer-Related Pain.

Authors:  David Hao; Michael Fiore; Christopher Di Capua; Amitabh Gulati
Journal:  Curr Pain Headache Rep       Date:  2022-09-27

3.  Adverse events related to ultrasound-guided regional anesthesia performed by Emergency Physicians: Systematic review protocol.

Authors:  Sean P Stickles; Deborah Shipley Kane; Chadd K Kraus; Robert J Strony; Enyo A Ablordeppey; Michelle M Doering; Daniel Theodoro; Jacques Simon Lee; Christopher R Carpenter
Journal:  PLoS One       Date:  2022-06-24       Impact factor: 3.752

4.  Defining an Ultrasound-guided Regional Anesthesia Curriculum for Emergency Medicine.

Authors:  Ryan V Tucker; William J Peterson; Jennifer T Mink; Lindsay A Taylor; Stephen J Leech; Arun D Nagdev; Megan Leo; Rachel Liu; Lori A Stolz; Ross Kessler; Creagh T Boulger; Elaine H Situ-LaCasse; Jacob O Avila; Robert Huang
Journal:  AEM Educ Train       Date:  2020-12-11

5.  How Many Ultrasound Examinations Are Necessary to Gain Proficiency in Accurately Identifying the Nerves of the Brachial Plexus at the Level of the Interscalene Space?

Authors:  Alan Shteyman; Saundra A Jackson; Tabitha Anne Campbell; Charlotte Derr
Journal:  J Emerg Trauma Shock       Date:  2021-12-24

6.  Challenges and Variations in Emergency Medicine Residency Training of Ultrasound-guided Regional Anesthesia Techniques.

Authors:  Casey Lee Wilson; Kevin Chung; Tiffany Fong
Journal:  AEM Educ Train       Date:  2017-02-18
  6 in total

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