Development and validation of an assessment tool for adult simulated ultrasound-guided fascia iliaca block: a prospective monocentric study.

Autor:	Guyader FP; Hospital European George Pompidou, Paris, France., Violeau M; Hospital Centre Niort, Niort, France., Guenezan J; Emergency Department and Prehospital Care, CHU Poitiers, Poitiers, France.; ABS-Lab, Poitiers University Faculty of Medicine and Pharmacy, Poitiers, France., Guechi Y; Emergency Department, Fribourg Hospitals, Fribourg, Switzerland., Breque C; Simulation Center, Poitiers University Faculty of Medicine and Pharmacy, Poitiers, France., Betoulle-Masset P; ABS-Lab, Poitiers University Faculty of Medicine and Pharmacy, Poitiers, France., Faure JP; Anatomy Laboratory, Poitiers University Faculty of Medicine and Pharmacy, Poitiers, France.; General Surgery, CHU Poitiers, Poitiers, France., Oriot D; Simulation Laboratory, Poitiers University Faculty of Medicine and Pharmacy, Poitiers, France.; Pediatric Emergency Department, CHU Poitiers, Poitiers, France., Ghazali DA; Emergency Department, University Hospital Centre Amiens-Picardie, Amiens, France aiham@hotmail.com.; Amiens University, Amiens, France.
Jazyk:	angličtina
Zdroj:	Emergency medicine journal : EMJ [Emerg Med J] 2024 May 28; Vol. 41 (6), pp. 354-360. Date of Electronic Publication: 2024 May 28.
DOI:	10.1136/emermed-2023-213123
Abstrakt:	Background: Fascia iliaca block (FIB) is an effective technique for analgesia. While FIB using ultrasound is preferred, there is no current standardised training technique or assessment scale. We aimed to create a valid and reliable tool to assess ultrasound-guided FIB. Method: This prospective observational study was conducted in the ABS-Lab simulation centre, University of Poitiers, France between 26-29 October and 14-17 December 2021. Psychometric testing included validity analysis and reliability between two independent observers. Content validity was established using the Delphi method. Three rounds of feedback were required to reach consensus. To validate the scale, 26 residents and 24 emergency physicians performed a simulated FIB on SIMLIFE, a simulator using a pulsated, revascularised and reventilated cadaver. Validity was tested using Cronbach's α coefficient for internal consistency. Comparative and Spearman's correlation analysis was performed to determine whether the scale discriminated by learner experience with FIB and professional status. Reliability was analysed using the intraclass correlation (ICC) coefficient and a correlation score using linear regression (R 2 ). Results: The final 30-item scale had 8 parts scoring 30 points: patient positioning, preparation of aseptic and tools, anatomical and ultrasound identification, local anaesthesia, needle insertion, injection, final ultrasound control and signs of local anaesthetic systemic toxicity. Psychometric characteristics were as follows: Cronbach's α was 0.83, ICC was 0.96 and R 2 was 0.91. The performance score was significantly higher for learners with FIB experience compared with those without experience: 26.5 (22.0; 29.0) vs 22.5 (16.0; 26.0), respectively (p=0.02). There was a significant difference between emergency residents' and emergency physicians' scores: 20.5 (17.0; 25.0) vs 27.0 (26.0; 29.0), respectively (p=0.0001). The performance was correlated with clinical experience (Rho=0.858, p<0.0001). Conclusion: This assessment scale was found to be valid, reliable and able to identify different levels of experience with ultrasound-guided FIB. Competing Interests: Competing interests: J-PF, DO, CB and DAG are co-inventors of patent no. 1000318748. SIMEDYS company has exclusive rights to exploit patent no. 1000318748. J-PF, J-PR, DO and CB are shareholders in SIMEDYS. P4P device which allows the revascularisation and reventilation of the cadaver is a trademark of SIMEDYS. All others authors declare that they have no conflict of interest. (© Author(s) (or their employer(s)) 2024. No commercial re-use. See rights and permissions. Published by BMJ.)
Databáze:	MEDLINE
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