Innovative Ultrasound-Guided Erector Spinae Plane Nerve Block Model for Training Emergency Medicine Physicians

Area of Science:

• Medical Education
• Regional Anesthesia
• Emergency Medicine

Background:

• The erector spinae plane (ESP) block is a recent regional anesthesia technique for thoracic neuropathic pain and acute rib fractures.
• Barriers to ESP block implementation in the emergency department (ED) include knowledge gaps and lack of standardized training.
• A novel, cost-effective ultrasound-guided ESP nerve block model was developed to facilitate physician training.

Purpose of the Study:

• To evaluate the effectiveness of a novel, inexpensive, and portable ultrasound-guided ESP nerve block model for emergency medicine (EM) physician training.
• To assess the impact of hands-on training with the simulation model on learners' knowledge, confidence, and skills in performing ESP blocks.

Main Methods:

• A cost-effective ESP nerve block model was created using a 3-D printed spine and ribcage suspended in ultrasound-compatible ballistics gel.
• A hands-on training module incorporated didactic lectures, live demonstrations, and practice sessions using the simulation model.
• Post-education surveys assessed participants' confidence, knowledge, and skills before and after the training session.

Main Results:

• All participants (100%) reported increased confidence, knowledge, and skills in performing ESP blocks after training with the model.
• 100% felt confident using ultrasound to identify landmarks on the model and found the training relevant to ED practice.
• Respondents identified time constraints and patient mobility as barriers, suggesting facilitators like increased access to supplies and more education.

Conclusions:

• The ballistics gel ESP nerve block model is an effective, realistic, and cost-efficient tool for improving physician competency in performing ESP blocks.
• Short training sessions with this model can significantly enhance skills and confidence, even for physicians new to nerve blocks.
• Addressing identified barriers can further increase the utilization of ESP blocks in the ED, potentially improving patient outcomes.