Design and Implementation of a Novel High-Fidelity Ultrasound-Guided Hematoma Block Model

Ultrasound-guided hematoma blocks are emerging as a safe alternative to both blind hematoma blocks and procedural sedations for reduction of distal forearm fractures in the Emergency Department. There are no commercially available high-fidelity models to practice this skill outside of the clinical environment. The purpose of this study is to develop a high-fidelity, reusable simulator for ultrasound-guided hematoma block training and to assess the impact of training with the model on procedural confidence among Emergency Medicine residents.

An ultrasound-guided forearm hematoma block model was designed and 3D-printed. Forty-five Emergency Medicine residents from three residency programs at the University of Arizona were recruited to participate in a simulation training with the model. Participants were enrolled by availability at a residency conference simulation session. The training included a didactic lecture followed by a hands-on simulator attempt. Participants completed a pre- and post-training confidence survey, rating procedural confidence on a Likert Scale. Participants rated seven aspects of procedural fidelity, six aspects of ultrasound fidelity, and overall model fidelity on a Likert scale after the training. Data from the confidence surveys were analyzed using Student’s t-tests with significance of p

Data from three participants who did not fully complete the pre-survey were excluded. Twenty-seven participants completed the post-training confidence and model fidelity surveys. Participants reported significantly improved confidence on each of the procedural steps and overall procedural confidence after the training (p=0.0001). The ultrasound-hematoma block model had realistic procedural, ultrasound, and overall model fidelity.

The ultrasound-guided hematoma block model provides a realistic training solution for improving procedural confidence among Emergency Medicine residents in a simulation environment.