Background : Hip fractures are a common occurrence in emergency departments (ED) that carry a high morbidity. Ultrasound-guided femoral nerve block is a more novel approach to pain control that reduces need for opiate use. Research has demonstrated that Ultrasound education of nerve blocks is less commonly taught than other ultrasound applications in many EM residencies. This likely impedes more frequent usage of this modality as the analgesic of choice in clinical practice for future EM physicians.
Purpose/Objective : Our primary objective is to determine the feasibility of using a low-fidelity ultrasound gel phantom to effectively teach Emergency Medicine the ultrasound-guided femoral nerve block procedure, as well as to asses the residents level of comfort before and after the educational intervention.
Methods : A low fidelity phantom was created to simulate the anatomy of the femoral nerve, artery, and vein. The model was constructed by mixing gelatin, fiber, and glycerin in water. Vein, artery, and nerve were created using water-filled balloons, water-filled jumbo straws, and spaghetti noodles inside water-filled balloons respectively . Residents of various training levels performed US-guided femoral nerve blocks on the model. Pre and post-intervention surveys were completed by residents assessing comfort with the procedure.
Outcomes : A total of 20 residents participated in the study from varying PGY-levels. Confidence in identifying the femoral nerve anatomy increased by 52.6%, 27.8%, an 40.3% respectively in PGY1-3's. Confidence in performing a femoral nerve block also increased by 50%, 34.4%, and 47.2% respectively. Residents were much more comfortable performing the ultrasound guided femoral nerve blocks after training on the the low fidelity phantom.