A low-cost, easy to make ultrasound phantom for training healthcare providers in pleural fluid identification and task simulation in ultrasound-guided thoracentesis

2017 ◽  
Vol 8 ◽  
pp. 80-81 ◽  
Author(s):  
Juliana Wilson ◽  
Carrie Myers ◽  
Resa E. Lewiss
Author(s):  
Shiv Kumar Singh ◽  
Tuhin Mistry

Introduction In most of the ultrasound guided regional anaesthesia workshops, anaesthesiologists usually concentrate on identification of nerves & plexus on human volunteers and practice needling techniques on phantom. Proper needle insertion technique and correct manipulation are two important skills for ultrasound-guided peripheral nerve blocks. These skills can be sharpened by practicing on ultrasound phantom. It also helps anaesthesiologists to develop, practice and maintain the skills needed for regional anaesthesia and vascular access procedures [1]. But the use of phantoms is often limited due to the cost of the blue phantom [2]. Many courses use meat-based products like turkey legs or porcine models but these may not be acceptable to everyone [3,4]. Vegetable based models using gelatine also may not be acceptable as it too is made from animal products. We describe novel use of Aloe Vera (AV)stem as phantom for US guided needling training. This natural AV gel-based phantom can be used for scanning, needling and refine other relevant skills. The AV phantom can be constructed from low cost, readily available natural source and is reusable. Various materials have been used to make ultrasound training phantoms. Commercially available phantoms are expensive and homemade nerve block models are cumbersome to prepare [5]. The Aloe Vera gel is obtained from Aloe Vera plant (Aloe barbadensis miller). It is a natural product which has been used for centuries in various field specially in dermatology. Aloe Vera leaves are triangular and fleshy with serrated edges. Each leaf contains an inner clear gel which is made of 99% water and other substances (glucomannans, amino acids, lipids, sterols and vitamins) [6]. Aloe Vera is odorless and semi-transparent unlike meat-based models. Preparing the Aloe Vera US Model The covering of the leaves is non-echogenic and hence the pulp from Aloe Vera leaves is separated and placed in layers and covered with a Transparent Dressing(Te


2014 ◽  
Vol 86 (4) ◽  
pp. 340 ◽  
Author(s):  
Lucio Dell’Atti

Objectives: We report in this singlecenter study our results of a five-year experience in the administration of lidocaine spray (LS) during ultrasound-guided prostate biopsy (TPB). Material and Methods: Between August 2008 and July 2013 a total of 1022 consecutive male patients scheduled for TPB with elevate PSA (≥ 4 ng/ml) and (or) abnormal digital rectal and (or) suspect TRUS were considered eligible for the study. Each patient was treated under local anaesthesia with LS (10 gr/100 ml), applied two minutes before the procedure. TPB was performed with the patient in the left lateral decubitus using multi-frequency convex probe “end-fire”. Two experienced urologists performed a 14-core biopsy, as first intention. After the procedure each patient was given a verbal numeric pain scale (VNS). The evaluation was differentiated in two scales VNS: VNS 1 for the insertion of the probe and the manoeuvres associated, while VNS 2 only for the pain during needle’s insertion. Results: Pain scores were not statistically significant different with regard to the values of PSA and prostate gland volume. Pain score levels during probe insertion and biopsy were significantly different: the mean pain score according to VNS was 3.3 (2-8) in the first questionnaire (VNS1) (p < 0.001) and 2.1 (1-7) in the second one (VNS2) (p < 0.125). The 8.2% of cases referred severe or unbearable pain (score ≥ 7), 74% of patients referred no pain at all. Only 21 patients would not ever repeat the biopsy or would request a different type of anaesthesia, while 82% of them would repeat it in the same way. In only eight patients we have not been able to insert TRUS probe. Conclusions: Our pain score data suggest that LS provides efficient patient comfort during TPB reducing pain both during insertion of the probe and the needle. This non-infiltrative anaesthesia is safe, easy to administer, psychologically well accepted by patients and of low cost.


Urology ◽  
2018 ◽  
Vol 115 ◽  
pp. 45-50 ◽  
Author(s):  
James Nonde ◽  
Ahmed Adam ◽  
Abdullah Ebrahim Laher

2017 ◽  
Vol 37 (2) ◽  
pp. 493-500 ◽  
Author(s):  
Ashley Sullivan ◽  
Lyudmila Khait ◽  
Mark Favot

Author(s):  
Keryl A. Cosenzo

The research objective was to evaluate cerebral blood flow velocity's (BFV) sensitivity to performance changes in a multitasking setting and to examine resulting constraints on multitasking. The research used a Transcranial Doppler Sonography (TCD) unit and multitask environment simulation. The tasks represented the diverse nature of the future military environment and included visual tracking, auditory monitoring, and more complex cognitive tasks requiring mental manipulations and memory. Participants completed four tasks simultaneously but with varying priority. BFV and multitask performance were measured. Results showed that BFV changed during training and paralleled a performance change. BFV was not sensitive to changes in task load during multitasking. We did show behavioral consequences to multitasking, specifically when transitioning between tasks. The data suggest that BFV may not be the most direct neurophysiological method for measuring complex cognitive performance; however, the use of this type of portable and relatively low-cost methodology should be pursued further.


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