Implementation of regional anesthesia education for emergency medicine residents and faculty

IF 1.7 Q2 EDUCATION, SCIENTIFIC DISCIPLINES

AEM Education and Training Pub Date : 2025-03-11 DOI:10.1002/aet2.70007

Anthony Rauschenbach MD, Glenn Paetow MD, Hayley Musial MD, Andrew Laudenbach MD, Daniel Parsons-Moss MD, Sarah Knack MD, Andrea Dreyfuss MD

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引用次数: 0

Abstract

Background

Using opioids for pain management in emergency departments (ED) poses risks such as respiratory depression and addiction. Ultrasound-guided regional anesthesia (UGRA) offers an alternative to opioids and procedural sedation, yet many emergency medicine (EM) residencies lack formal training for this skill. It is crucial to develop education initiatives aimed at incorporating UGRA techniques into clinical practice for emergency physicians (EPs).

Methods

A regional anesthesia education program for EM residents and faculty was piloted. The intervention comprised a 25-min video on safe UGRA practices followed by a 4-h hands-on course using cadaveric and live models. Participant knowledge was tested before the course and 6 weeks afterward. Test results were analyzed via paired t-test. The electronic health record was reviewed for UGRA blocks performed in the ED 2 months before and after the intervention. Efficacy was evaluated through patient-reported pain improvement and ultrasound image review. Immediate complications are reported.

Results

Twenty-six residents and 11 faculty completed the video review, hands-on course, and the pre/posttests. With a maximum score of 30, median (IQR) pretest scores were 14 (12–17) and increased to 21 (18–23) 6 weeks postcourse, with a median 8 (95% CI 4.1–9.0) points improvement. One-hundred percent of participants found the training helpful. Clinical data were collected from August 26, 2023, to December 25, 2023, and the number of UGRA blocks performed rose from 55 before to 102 after the intervention. Pain improvement was similar before and after the intervention. Review of recorded images indicated proper needle position and anesthetic spread in 91% of blocks precourse and 82% postcourse.

Conclusions

This educational intervention increased UGRA blocks with few complications and a high success rate. Provider knowledge significantly improved, but needle positioning and anesthetic spread were inappropriate in 18% of blocks postcourse, emphasizing the need for ongoing education to enhance UGRA competency among EPs.

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背景在急诊科（ED）使用阿片类药物进行疼痛治疗存在呼吸抑制和成瘾等风险。超声引导下区域麻醉（UGRA）是阿片类药物和手术镇静的替代方法，但许多急诊医学（EM）住院医师缺乏这方面技能的正规培训。制定旨在将 UGRA 技术纳入急诊医师（EPs）临床实践的教育计划至关重要。方法为急诊科住院医师和教师试行了一项区域麻醉教育计划。干预措施包括播放一段 25 分钟的 UGRA 安全操作视频，然后使用尸体和活体模型进行 4 小时的实践课程。课程前和课程后 6 周对参与者进行了知识测试。测试结果通过配对 t 检验进行分析。对干预前后 2 个月在急诊室进行的 UGRA 阻滞进行了电子健康记录审查。疗效通过患者报告的疼痛改善情况和超声图像审查进行评估。报告了即时并发症。结果 26 名住院医师和 11 名教师完成了视频回顾、实践课程和前后测试。在最高分 30 分的情况下，课程前测试得分的中位数（IQR）为 14 分（12-17），课程后 6 周得分增至 21 分（18-23），中位数提高了 8 分（95% CI 4.1-9.0）。100%的参与者认为培训很有帮助。临床数据收集时间为 2023 年 8 月 26 日至 2023 年 12 月 25 日，进行 UGRA 阻滞的次数从干预前的 55 次增加到干预后的 102 次。干预前后疼痛改善情况相似。对记录图像的审查表明，91% 的阻滞术前和 82% 的阻滞术后都有正确的针位和麻药扩散。结论这种教育干预增加了 UGRA 阻滞，并发症少，成功率高。医护人员的知识水平明显提高，但课程结束后有 18% 的阻滞中针头位置和麻醉剂扩散不恰当，这强调了持续教育的必要性，以提高 EPs 的 UGRA 能力。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

AEM Education and Training Nursing-Emergency Nursing

CiteScore

2.60

自引率

22.20%

发文量