Model for Ultrasound‐Assisted Lumbar Puncture Training

Abstract

Lumbar puncture is an important diagnostic procedure in emergency medicine. Data have been published showing improved success rate with ultrasound assistance and the ability of emergency medicine physicians to recognize sonographic lumbar spinous anatomy. However, with educational models and the push for improved patient safety, procedural skills should be practiced on phantoms rather than the “see one, do one, teach one” of the past. There are no currently available phantoms for ultrasound‐assisted lumbar puncture training. We have produced a phantom that can be used to train physicians on ultrasound‐assisted lumbar puncture with respect to both imaging and procedural competency. A plastic fluid‐filled bladder was immersed in gelled opacified mineral oil, a safe and easily used tissue mimic that obscures direct visualization of structures. Spinous anatomy is replicated with the use of wooden struts supporting wooden disks that mimic lumbar spinous processes. The spine analog was mounted over the plastic bladder and surrounded with gelled mineral oil. The phantom produces images similar to human lumbar anatomy. The phantom allows insertion of spinal needles into the “interspinous spaces” with inability to pass the needle outside of those locations. Fluid collection and repeated punctures can be performed on the phantom. Appearance and performance of the phantom were evaluated by physicians with expertise in ultrasound‐assisted lumbar puncture. The only limitation is that external appearance is not realistic. This model performs well, is made from readily available materials, and can be used to train physicians in ultrasound‐assisted lumbar puncture.

Versatile, Reusable, and Inexpensive Ultrasound Phantom Procedural Trainers

“…The high cost of US simulation phantoms has led teachers to explore alternatives, including cadavers and homemade alternatives 10 using culinary gelatin 11 – 15 or animal products 16 – 19 . Each method accepts several disadvantages of the proposed materials in exchange for its much lower cost: the phantoms require careful storage, break down with multiple uses, and degrade and mold over short periods.…”