An Ultrasound-Guided Regional Anesthesia Elective for Emergency Medicine Residents

AUDIENCE: This ultrasound-guided regional anesthesia elective is designed for emergency medicine residents. LENGTH OF CURRICULUM: The proposed length of this curriculum is over one week. INTRODUCTION: Ultrasound-guided regional anesthesia (UGRA) is a useful tool in the emergency department (ED) for managing painful conditions, and many programs have identified that these are useful skills for emergency providers; however, only about 53% of programs report teaching UGRA as part of their core curriculum, and there currently are no widely available or peer reviewed nerve block curricula designed for emergency medicine residents. EDUCATIONAL GOALS: To deliver an immersive 1-week elective to provide residents a strong foundation in principles of UGRA and an introduction to 14 nerve block procedures applicable to care provided in the ED. EDUCATIONAL METHODS: The educational strategies used in this curriculum include: instructional videos, written and online independent learning materials, one-on-one teaching at the bedside with an emergency ultrasound fellow, simulation of nerve block techniques using a femoral nerve block task trainer, and performance of supervised nerve block procedures on patients in the ED. RESEARCH METHODS: All residents provided feedback through an online survey after completing the elective. RESULTS: Eight residents completed the elective in the first year of implementation. Following completion of the UGRA curriculum, 8/8 (100%) of residents reported increased level of confidence in performing UGRA. In addition, 8/8 (100%) of residents reported they were “likely” or “very likely” to incorporate UGRA into their future EM practice. All 8 (100%) residents responded they were “very likely” to recommend the elective to other trainees. The elective received high ratings for overall quality with an average rating of 9.4 out of 10 (±0.7). DISCUSSION: An elective in ultrasound-guided regional anesthesia can be successfully incorporated into an emergency medicine training program. The curriculum was successful in providing focused training in UGRA and resulted in increased resident confidence in performing nerve block procedures. TOPICS: Ultrasound-guided regional anesthesia, nerve block, resident, elective, pain.