Ultrasound-guided nerve blocks--is documentation and education feasible using only text and pictures?

<h4>Purpose</h4>With the advancement of ultrasound-guidance for peripheral nerve blocks, still pictures from representative ultrasonograms are increasingly used for clinical procedure documentation of the procedure and for educational purposes in textbook materials. However, little is ac...

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Autores principales:	Bjarne Skjødt Worm, Mette Krag, Kenneth Jensen
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2014
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/39150159404d47ceb0d7f52958b4584f
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spelling	oai:doaj.org-article:39150159404d47ceb0d7f52958b4584f2021-11-18T08:32:53ZUltrasound-guided nerve blocks--is documentation and education feasible using only text and pictures?1932-620310.1371/journal.pone.0086966https://doaj.org/article/39150159404d47ceb0d7f52958b4584f2014-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/24533051/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Purpose</h4>With the advancement of ultrasound-guidance for peripheral nerve blocks, still pictures from representative ultrasonograms are increasingly used for clinical procedure documentation of the procedure and for educational purposes in textbook materials. However, little is actually known about the clinical and educational usefulness of these still pictures, in particular how well nerve structures can be identified compared to real-time ultrasound examination. We aimed to quantify gross visibility or ultrastructure using still picture sonograms compared to real time ultrasound for trainees and experts, for large or small nerves, and discuss the clinical or educational relevance of these findings.<h4>Materials and methods</h4>We undertook a clinical study to quantify the maximal gross visibility or ultrastructure of seven peripheral nerves identified by either real time ultrasound (clinical cohort, n = 635) or by still picture ultrasonograms (clinical cohort, n = 112). In addition, we undertook a study on test subjects (n = 4) to quantify interobserver variations and potential bias among expert and trainee observers.<h4>Results</h4>When comparing real time ultrasound and interpretation of still picture sonograms, gross identification of large nerves was reduced by 15% and 40% by expert and trainee observers, respectively, while gross identification of small nerves was reduced by 29% and 66%. Identification of within-nerve ultrastructure was even less. For all nerve sizes, trainees were unable to identify any anatomical structure in 24 to 34%, while experts were unable to identify anything in 9 to 10%.<h4>Conclusion</h4>Exhaustive ultrasonography experience and real time ultrasound measurements seem to be keystones in obtaining optimal nerve identification. In contrast the use of still pictures appears to be insufficient for documentation as well as educational purposes. Alternatives such as video clips or enhanced picture technology are encouraged instead of still pictures extracted from basic ultrasonograms.Bjarne Skjødt WormMette KragKenneth JensenPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 9, Iss 2, p e86966 (2014)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Bjarne Skjødt Worm Mette Krag Kenneth Jensen Ultrasound-guided nerve blocks--is documentation and education feasible using only text and pictures?
description	<h4>Purpose</h4>With the advancement of ultrasound-guidance for peripheral nerve blocks, still pictures from representative ultrasonograms are increasingly used for clinical procedure documentation of the procedure and for educational purposes in textbook materials. However, little is actually known about the clinical and educational usefulness of these still pictures, in particular how well nerve structures can be identified compared to real-time ultrasound examination. We aimed to quantify gross visibility or ultrastructure using still picture sonograms compared to real time ultrasound for trainees and experts, for large or small nerves, and discuss the clinical or educational relevance of these findings.<h4>Materials and methods</h4>We undertook a clinical study to quantify the maximal gross visibility or ultrastructure of seven peripheral nerves identified by either real time ultrasound (clinical cohort, n = 635) or by still picture ultrasonograms (clinical cohort, n = 112). In addition, we undertook a study on test subjects (n = 4) to quantify interobserver variations and potential bias among expert and trainee observers.<h4>Results</h4>When comparing real time ultrasound and interpretation of still picture sonograms, gross identification of large nerves was reduced by 15% and 40% by expert and trainee observers, respectively, while gross identification of small nerves was reduced by 29% and 66%. Identification of within-nerve ultrastructure was even less. For all nerve sizes, trainees were unable to identify any anatomical structure in 24 to 34%, while experts were unable to identify anything in 9 to 10%.<h4>Conclusion</h4>Exhaustive ultrasonography experience and real time ultrasound measurements seem to be keystones in obtaining optimal nerve identification. In contrast the use of still pictures appears to be insufficient for documentation as well as educational purposes. Alternatives such as video clips or enhanced picture technology are encouraged instead of still pictures extracted from basic ultrasonograms.
format	article
author	Bjarne Skjødt Worm Mette Krag Kenneth Jensen
author_facet	Bjarne Skjødt Worm Mette Krag Kenneth Jensen
author_sort	Bjarne Skjødt Worm
title	Ultrasound-guided nerve blocks--is documentation and education feasible using only text and pictures?
title_short	Ultrasound-guided nerve blocks--is documentation and education feasible using only text and pictures?
title_full	Ultrasound-guided nerve blocks--is documentation and education feasible using only text and pictures?
title_fullStr	Ultrasound-guided nerve blocks--is documentation and education feasible using only text and pictures?
title_full_unstemmed	Ultrasound-guided nerve blocks--is documentation and education feasible using only text and pictures?
title_sort	ultrasound-guided nerve blocks--is documentation and education feasible using only text and pictures?
publisher	Public Library of Science (PLoS)
publishDate	2014
url	https://doaj.org/article/39150159404d47ceb0d7f52958b4584f
work_keys_str_mv	AT bjarneskjødtworm ultrasoundguidednerveblocksisdocumentationandeducationfeasibleusingonlytextandpictures AT mettekrag ultrasoundguidednerveblocksisdocumentationandeducationfeasibleusingonlytextandpictures AT kennethjensen ultrasoundguidednerveblocksisdocumentationandeducationfeasibleusingonlytextandpictures
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Ultrasound-guided nerve blocks--is documentation and education feasible using only text and pictures?

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