About this trial
Ultrasound-guided regional anesthesia/analgesia techniques (or simply, 'regional blocks') have gained popularity as they can reduce, and sometimes even eliminate, the need for opiate analgesics (and, consequently, their side effects), thereby improving patient safety, reducing length of hospital stay and medical costs, and improving patient satisfaction. However, a major barrier to mainstream uptake of such techniques relates to training. These techniques require the acquisition of new skills under expert guidance, which is often not possible given the daily demands placed upon anesthesiologists. As a result, many opportunities for providing regional blocks may be missed.
The purpose of this study is to implement a new real-time 'near remote' guidance method in which trainees who are to perform regional blocks can do so via tele-mentoring under expert guidance. This will be done using a novel technology whereby the ultrasound image is concurrently displayed on an iPad screen (for the block operator/trainee) as well as on the (near remotely supervising) expert mentor's smartphone. Trainees and mentors will use this method to perform various standard of care regional blocks, either in the perioperative or emergency department settings. Participants' opinions of the novel teaching and learning method will be assessed.
Eligibility criteria
This trial accepts healthy volunteersQualifiers
Mentors: Staff anesthesiologists who are experts in regional blocks.
Trainees: Senior (PGY3-5) residents (anesthesiology and emergency medicine), and staff (emergency medicine) physicians who have already performed and are comfortable with being supervised near remotely for the regional block at hand.
Patients: Greater or equal to 18 years of age presenting for surgery or with traumatic injuries amenable to regional blocks.
All of the above: Able to read and understand English, and competent to provide written informed consent.
Disqualifiers
Mentors: Staff anesthesiologists who are not experts in the performance/teaching of regional blocks.
Trainees: Junior (PGY1-2) residents (for any/all types of regional blocks), and senior (PGY3-5) residents and staff physicians who are not comfortable with being supervised near remotely for the regional block at hand.
Patients: Less than 18 years of age.
All of the above: Unable to read and understand English, and not competent to provide written informed consent.
Trial population
Participants will include: (1) mentors, i.e., staff regional anesthesiologists who are experts in ultrasound-guided regional blocks; (2) trainees, i.e., PGY-3 to PGY-5 anesthesia and emergency medicine residents, and emergency medicine staff physicians; and (3) patients, i.e., individuals 18 years and older scheduled for surgery amenable to regional blocks or presenting to the emergency department with traumatic injuries amenable to regional blocks.
Trial design
Other
Prospective
Treatments tested in this trial
Real time 'near remote' guidance of regional blocks
Procedure/SurgeryTrainees who are to perform regional blocks will do so under expert guidance via tele-mentoring. This will be done using a novel technology consisting of a wirelessly linked iPad which will display the ultrasound image to the block operator/trainee. This image will be concurrently visualized by an expert mentor through their smartphone, who will then provide feedback/guidance in real-time to the operator/trainee.
Treatment groups
Trial outcomes
Primary outcomes
Participant opinion
The investigators will assess the opinions of mentors and trainees regarding the use of 'near-remote' guidance for the performance of ultrasound-guided regional blocks.
Secondary outcomes
Block success
Patients' sensation to ice
Block image
Saved ultrasound image at the end of the block procedure. Specifically, this image will be saved after completion of local anesthetic injection and before removal of the block needle for subsequent review by a blinded expert.
Complications
Any complications associated with performed regional blocks
Patient satisfaction
Patient satisfaction with block performance
Sponsors and contacts
Click on the lead sponsor to view all of their trials.
Dr. Glenio Mizubuti (MD, PhD)
Lead sponsor
Queen's University
Sponsor institution