{"pk":13235,"title":"Ultrasound Identification of Retrobulbar Hematomas by Emergency Physicians in a Cadaveric Model","subtitle":null,"abstract":"Introduction:\n Retrobulbar hemorrhage (RBH) is a rare complication of facial trauma that can lead to dangerous orbital compartment pressures and must be rapidly recognized to prevent permanent vision loss. Point-of-care ultrasound (POCUS) offers a rapid modality for evaluating a wide variety of ocular pathologies, and prior case reports demonstrate the ability of clinicians to recognize RBH using ultrasound. This study aimed to assess the ability of clinicians at various stages of training to identify a RBH using POCUS in a cadaveric model. Clinicians also were assessed for self-reported comfort using ultrasound for ocular pathology before and after the study.\nMethods:\n Participants included 17 physicians who evaluated 10 eyes (from five cadavers) that were independently randomized to have either a modeled RBH or no hemorrhage. Participants’ final diagnosis of each eye was recorded (RBH present or not), and participants also completed pre- and post-activity surveys.\nResults:\n The overall sensitivity and specificity to correctly diagnose retrobulbar fluid was 87% and 88%, respectively. Sensitivity and specificity were higher after excluding clinicians in their early phase of training. Additionally, self-reported comfort level with ocular ultrasound was significantly improved by this activity.\nConclusion:\n Emergency physicians at a variety of training levels can correctly identify a cadaveric model of retrobulbar hemorrhage. Use of this cadaveric model can improve exposure of clinicians to the appearance of a rare but vision-threatening ocular pathology such as RBH.","language":"en","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[{"word":"ultrasound"},{"word":"retrobulbar hemorrhage"},{"word":"Ocular Trauma"}],"section":"Technology in Emergency Medicine","is_remote":true,"remote_url":"https://escholarship.org/uc/item/0zt2q4pq","frozenauthors":[{"first_name":"Edward","middle_name":"","last_name":"Carlin","name_suffix":"","institution":"North Shore University Hospital, Department of Emergency Medicine, Manhasset, New York;\nNorth Shore University Hospital, Department of Emergency Medicine, Division of Emergency Ultrasound, Manhasset, New York","department":"None"},{"first_name":"Alexa","middle_name":"","last_name":"Palmieri","name_suffix":"","institution":"North Shore University Hospital, Department of Emergency Medicine, Manhasset, New York","department":"None"},{"first_name":"Tanya","middle_name":"","last_name":"Bajaj","name_suffix":"","institution":"North Shore University Hospital, Department of Emergency Medicine, Manhasset, New York","department":"None"},{"first_name":"Mathew","middle_name":"","last_name":"Nelson","name_suffix":"","institution":"North Shore University Hospital, Department of Emergency Medicine, Manhasset, New York;\nNorth Shore University Hospital, Department of Emergency Medicine, Division of Emergency Ultrasound, Manhasset, New York","department":"None"}],"date_submitted":"2019-09-05T16:38:50Z","date_accepted":"2019-09-05T16:38:50Z","date_published":"2020-04-13T22:17:14Z","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/westjem/article/13235/galley/6969/download/"}]}