A low fidelity eye model for lateral canthotomy training

Kong, Rodrigo; Kaya, Dersim Pascal; Cioè-Peña, Eric; Greenstein, Josh

doi:10.1016/j.afjem.2018.02.002

Cited by 13 publications

(17 citation statements)

References 9 publications

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“…Based on the limited opportunity for repeated practice and feedback, it would be very difficult for confidence levels to increase by much more than this; ideally, in the future, this skill is taught on a task trainer that allows repeated practice. Due to a lack of models, evidence on this topic is limited . This procedure is often taught on cadavers, but, due to dehydration, the globe is not under tension and identification of the relevant anatomy can be difficult.…”

Section: Discussionmentioning

confidence: 99%

“…Due to a lack of models, evidence on this topic is limited. [14][15][16] This procedure is often taught on cadavers, but, due to dehydration, the globe is not under tension and identification of the relevant anatomy can be difficult. Although our model was not explicitly compared to cadavers without the balloon, anecdotally we believe the presence of the balloon in the orbit better mimics this pathology by putting the globe under pressure.…”

Section: Discussionmentioning

confidence: 99%

“…Currently, there are limited options for learning this skill in the simulation environment. These options include porcine and human cadaver models, as well as synthetic task trainers with varied levels of fidelity …”

mentioning

confidence: 99%

“…These options include porcine and human cadaver models, 13,14 as well as synthetic task trainers with varied levels of fidelity. 15,16 We believe that lateral canthotomy and cantholysis is a skill that all junior OtoHNS residents should possess, and therefore we sought to create a realistic model of a RH such that the residents could learn on it to address this notable void. We aimed to determine the success of the model in this pilot study by evaluating the confidence of the residents before and after boot camp.…”

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confidence: 99%

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Development of a novel simulation‐based task trainer for management of retrobulbar hematoma

Chin

Clark

Roth

et al. 2019

Int Forum Allergy Rhinol

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Background Retrobulbar hematoma (RH) is a rare but devastating complication of sinus surgery. It is treated initially with a lateral canthotomy and cantholysis at the bedside. Due to the high stakes and urgency of this complication, teaching this in the clinical setting is difficult. The objective of this study was to develop a cadaveric model for addressing this problem. Methods A fresh‐frozen human cadaveric model of RH was created using a Foley catheter to simulate elevated intraocular pressure. Residents who participated in an emergencies in otolaryngology–head & neck surgery “boot camp” were included in the study. A survey measuring confidence levels in performing lateral canthotomy and cantholysis was administered. After completing the skill station, a postintervention survey was administered to assess the confidence of the learner as well as fidelity and usefulness of the task trainer. Results Thirty‐three residents participated in the boot camp. Residents rated their confidence preintervention at 1.3/5, which suggests the majority were unable to perform the procedure. After using the model, residents rated their confidence at 3.5/5, which falls between basic knowledge and reasonably confident; this improvement achieved statistical significance (p < 0.0001). The fidelity of the model was rated 3.9/5; a score of 4 is defined as realistic. The residents rated the usefulness of the model as 4.7; a score of 5 is defined as very useful. Conclusion A cadaveric model of RH was successfully developed. This novel simulator was perceived to be useful, realistic, and effective by junior residents.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

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Development of a novel simulation‐based task trainer for management of retrobulbar hematoma

Chin

Clark

Roth

et al. 2019

Int Forum Allergy Rhinol

View full text Add to dashboard Cite

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“…With the recent mandate from the Department of Defense to reduce the use of animals for medical training in favor of alternative methods, it is important to understand the potential advantages of non-biological simulators. These may include the promotion of patient safety, cost savings, the ability to customize teaching opportunities to individual learner needs, acquiring a range of surgical skills without compromising patient safety or comfort, increased exposure to complex and life-threatening events that may be lacking due to short hospital stays or restriction in work hours, and “warming up” before starting an operation [4-5, 7]. Each of the aforementioned items is particularly applicable to deployed medical personnel who may lack the time, equipment, or patient volume necessary to maintain an appropriate level of surgical skill.…”

Section: Discussionmentioning

confidence: 99%

Simulator Availability in Meeting the Requirements of United States Army Ophthalmology Individual Critical Task Lists

Anthony

Boden

Legault

2019

Cureus

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IntroductionIndividual Critical Task Lists (ICTLs) are a list of requirements set forth by the United States Army which each soldier must fulfill to maintain competency in a specialty. By providing senior leadership objective criteria with which to evaluate the competency of each service member, ICTLs support commanders in ensuring that soldiers are mission ready and deployable. Board-certified ophthalmologists can meet ICTL requirements by demonstrating skills on an actual patient, a simulator, and/or cadaveric or live tissue. We sought to determine the availability of simulators that can be used to meet Army ophthalmology ICTL requirements.MethodsWe reviewed the current Army ICTLs for ophthalmologists. We performed an online search, as well as an extensive review of Pubmed, AccessMedicine, Academic Search Elite, Thieme, and ScienceDirect, to identify available simulators for each ICTL. We did not use any date or language restrictions in the electronic search for trials. We last searched the electronic databases on April 27, 2019.ResultsArmy Ophthalmologists are required to maintain current status in 19 areas based on ICTLs established by the Critical Task Site and Selection Board. Eight of these requirements are not amenable to a simulation of any kind. Of the 11 remaining ICTLs, approximately 82% can be satisfied with a simulator alone based on current simulator availability. The remaining 18% of applicable ICTLs can be satisfied using cadaveric or live tissue training.ConclusionsArmy ophthalmologists can keep current with their ICTLs, and thus maintain mission readiness, by using either simulators or cadaveric or live tissues. This is particularly important for ophthalmologists who are either located in remote or austere locations without resources or areas with low surgical volumes. Several tasks are applicable to other medical specialties which can benefit from the same simulators.

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Orbital compartment syndrome: Pearls and pitfalls for the emergency physician

et al. 2021

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Orbital compartment syndrome (OCS) is a rare, vision‐threatening diagnosis that requires rapid identification and immediate treatment for preservation of vision. Because of the time‐sensitive nature of this condition, the emergency physician plays a critical role in the diagnosis and management of OCS, which is often caused by traumatic retrobulbar hemorrhage. In this review, we outline pearls and pitfalls for the identification and treatment of OCS, highlighting lateral canthotomy and inferior cantholysis (LCIC), a crucial skill for the emergency physician. We recommend adequate preparation for the diagnosis and procedure, early consultation to ophthalmology, clear and thorough documentation of the physical examination, avoidance of iatrogenic injury during LCIC, and complete division of the inferior canthal tendon. Emergency physicians should avoid failing to make the diagnosis of OCS, delaying definitive surgical treatment, overrelying on imaging, failing to decrease intraocular pressure, and failing to exclude globe rupture. The emergency physician should be appropriately trained to identify signs and symptoms of OCS and perform LCIC in a timely manner.

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A low fidelity eye model for lateral canthotomy training

Abstract: We introduce a low-fidelity, low-cost, reusable training model for the lateral canthotomy procedure. We believe that this trainer has the potential to improve clinicians’ knowledge and skill of the procedure, especially when cost or access to higher-fidelity trainers is prohibitive.

Cited by 13 publications

References 9 publications

Development of a novel simulation‐based task trainer for management of retrobulbar hematoma

Development of a novel simulation‐based task trainer for management of retrobulbar hematoma

Simulator Availability in Meeting the Requirements of United States Army Ophthalmology Individual Critical Task Lists

Orbital compartment syndrome: Pearls and pitfalls for the emergency physician

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