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{
    "pk": 8170,
    "title": "Performance Accuracy of Hand-on-needle versus Hand-on-syringe Technique for Ultrasound-guided Regional Anesthesia Simulation for Emergency Medicine Residents",
    "subtitle": null,
    "abstract": "Objectives: \nUltrasound-guided nerve blocks (UGNBs) are increasingly used in emergency care. The hand-on-syringe (HS) needle technique is ideally suited to the Emergency Department setting because it allows a single operator to perform the block without assistance.  The HS technique is assumed to provide less exact needle control than the alternative two operator hand-on-needle (HN) technique; however this assumption has never been directly tested.\n \nThe primary objective of this study was to compare\n \naccuracy of needle targeting under ultrasound guidance by Emergency Medicine (EM) residents using HN and HS techniques on a standardized gelatinous simulation model.\n \nMethods: \nThis prospective, randomized study evaluated task performance. Needle targeting accuracy using the HN and HS techniques was compared. Each participant performed a set of structured needling maneuvers (both simple and difficult) on a standardized partial-task simulator. Time to task completion, needle visualization during advancement, and accuracy of needle tip at targeting were evaluated. Resident technique preference was assessed using a post-task survey.\n \nResults: \n60 tasks performed by 10 EM residents were evaluated. There was no significant difference in time to complete the simple model (HN vs. HS, 18 seconds vs. 18 seconds, p=0.93), time to complete the difficult model (HN vs. HS, 56 seconds vs. 50 seconds, p=0.63), needle visualization, or needle tip targeting accuracy. Most residents (60%) preferred the HS technique.\n \nConclusion: \nFor EM residents learning UGNBs, the HN technique was not associated with superior needle control.  Our results suggest that the single operator HS technique provides equivalent needle control when compared to the two-operator HN technique.",
    "language": "en",
    "license": {
        "name": "Creative Commons Attribution-NonCommercial  4.0",
        "short_name": "CC BY-NC 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\nNonCommercial — You may not use the material for commercial purposes.\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-nc/4.0"
    },
    "keywords": [
        {
            "word": "emergency medical services"
        },
        {
            "word": "anesthesia"
        },
        {
            "word": "ultrasonography"
        },
        {
            "word": "Education, Medical"
        },
        {
            "word": "nerve block"
        }
    ],
    "section": "Education",
    "is_remote": true,
    "remote_url": "https://escholarship.org/uc/item/6w46537s",
    "frozenauthors": [
        {
            "first_name": "Brian",
            "middle_name": "",
            "last_name": "Johnson",
            "name_suffix": "",
            "institution": "Highland Hospital, Alameda Health System, Oakland, CA",
            "department": "None"
        },
        {
            "first_name": "Andrew",
            "middle_name": "",
            "last_name": "Herring",
            "name_suffix": "",
            "institution": "Highland Hospital, Alameda Health System, Oakland, CA\nUniversity of California San Francisco, San Francisco, CA",
            "department": "None"
        },
        {
            "first_name": "Michael",
            "middle_name": "",
            "last_name": "Stone",
            "name_suffix": "",
            "institution": "Brigham and Women’s Hospital, Harvard Medical School, Boston, MA",
            "department": "None"
        },
        {
            "first_name": "Arun",
            "middle_name": "",
            "last_name": "Nagdev",
            "name_suffix": "",
            "institution": "Highland Hospital, Alameda Health System, Oakland, CA\nUniversity of California San Francisco, San Francisco, CA",
            "department": "None"
        }
    ],
    "date_submitted": "2014-04-11T20:14:42Z",
    "date_accepted": "2014-04-11T20:14:42Z",
    "date_published": "2014-08-13T15:21:50Z",
    "render_galley": null,
    "galleys": [
        {
            "label": "",
            "type": "pdf",
            "path": "https://journalpub.escholarship.org/westjem/article/8170/galley/4701/download/"
        }
    ]
}