Defining Ultrasound-Guided Nerve Block Competency for Emergency Medicine: A Delphi-Method Consensus Statement

Area of Science:

• Emergency Medicine
• Anesthesiology
• Medical Education

Background:

• Ultrasound-guided nerve blocks (UGNBs) are increasingly used in Emergency Department (ED) multi-modal analgesia.
• Current standards for Emergency Medicine (EM) clinician competency in UGNBs are variable.
• There is a need to establish clear competency definitions and training guidelines.

Purpose of the Study:

• To define competency standards for Emergency Medicine physicians performing UGNBs.
• To establish a national consensus on UGNB competency through expert agreement.
• To create a framework for UGNB training and credentialing in EM.

Main Methods:

• A modified Delphi method was employed, involving national experts in EM and Anesthesiology.
• A comprehensive literature review informed a 123-item questionnaire.
• Twenty-seven experts participated in two rounds of electronic voting, with consensus defined as 80% agreement.

Main Results:

• All 27 panelists completed both voting rounds.
• 61 out of 123 items achieved consensus.
• Consensus was reached on defining competency, teaching methods, assessment, and practice evaluation for UGNBs, with debate on minimum numbers and core privilege status.

Conclusions:

• This study presents the first national consensus defining UGNB competency for EM physicians.
• The 61 consensus items provide a framework for residency curricula, faculty development, and quality assurance.
• These recommendations can guide ACGME requirements and support the integration of UGNBs into EM training.