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Learning insertion of a Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) catheter : Is clinical experience necessary? A prospective trial
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- Engberg, Morten (författare)
- Copenhagen Academy for Medical Education and Simulation (CAMES), Centre for Human Resources and Education, the Capital Region of Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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- Mikkelsen, Soren (författare)
- The Mobile Emergency Care Unit, Department of Anaesthesiology and Intensive Care, Odense University Hospital, Odense, Denmark; The Prehospital Research Unit, Region of Southern Denmark, Odense University Hospital, Odense, Denmark; Department of Regional Health Research, University of Southern Denmark, Odense, Denmark
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- Hörer, Tal M., 1971- (författare)
- Örebro universitet,Institutionen för medicinska vetenskaper,Region Örebro län,Department of Cardiothoracic and Vascular Surgery and Department of Surgery, Faculty of Life Science,Örebro University Hospital
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- Lindgren, Hans (författare)
- Lund University,Lunds universitet,Kliniska Vetenskaper, Helsingborg,Sektion II,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Vaskulära sjukdomar - kliniska studier,Forskargrupper vid Lunds universitet,Clinical Sciences, Helsingborg,Section II,Department of Clinical Sciences, Lund,Faculty of Medicine,Vascular Diseases - Clinical Research,Lund University Research Groups,Helsingborg Hospital
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- Søvik, Edmund (författare)
- Department of Radiology and Nuclear Medicine, St. Olavs University Hospital, Trondheim, Norway
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- Frendø, Martin (författare)
- Copenhagen Academy for Medical Education and Simulation (CAMES), Centre for Human Resources and Education, the Capital Region of Denmark; Department of Plastic and Reconstructive Surgery, Copenhagen University Hospital Herlev, Denmark,Gentofte Hospital
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- Svendsen, Morten Bo (författare)
- Copenhagen Academy for Medical Education and Simulation (CAMES), Centre for Human Resources and Education, the Capital Region of Denmark
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- Lönn, Lars (författare)
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; Department of Radiology, Copenhagen University Hospital Rigshospitalet, Denmark
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- Konge, Lars (författare)
- Copenhagen Academy for Medical Education and Simulation (CAMES), Centre for Human Resources and Education, the Capital Region of Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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- Russell, Lene (författare)
- Copenhagen Academy for Medical Education and Simulation (CAMES), Centre for Human Resources and Education, the Capital Region of Denmark; Department of Anaesthesiology and Intensive Care, Copenhagen University Hospital Gentofte, Denmark
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- Taudorf, Mikkel (författare)
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; Department of Radiology, Copenhagen University Hospital Rigshospitalet, Denmark
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(creator_code:org_t)
- Elsevier, 2023
- 2023
- Engelska.
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Ingår i: Injury. - : Elsevier. - 0020-1383 .- 1879-0267. ; 54:5, s. 1321-1329
- Relaterad länk:
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http://dx.doi.org/10...
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https://urn.kb.se/re...
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https://doi.org/10.1...
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https://lup.lub.lu.s...
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Abstract
Ämnesord
Stäng
- Background: Resuscitative endovascular balloon occlusion of the aorta (REBOA) is an emerging and po-tentially life-saving procedure, necessitating qualified operators in an increasing number of centres. The procedure shares technical elements with other vascular access procedures using the Seldinger technique, which is mastered by doctors not only in endovascular specialties but also in trauma surgery, emergency medicine, and anaesthesiology. We hypothesised that doctors mastering the Seldinger technique (expe-rienced anaesthesiologist) would learn the technical aspects of REBOA with limited training and remain technically superior to doctors unfamiliar with the Seldinger technique (novice residents) given similar training.Methods: This was a prospective trial of an educational intervention. Three groups of doctors were en-roled: novice residents, experienced anaesthesiologists, and endovascular experts. The novices and the anaesthesiologists completed 2.5 h of simulation-based REBOA training. Their skills were tested before and 8-12 weeks after training using a standardised simulated scenario. The endovascular experts, con-stituting a reference group, were equivalently tested. All performances were video recorded and rated by three blinded experts using a validated assessment tool for REBOA (REBOA-RATE). Performances were compared between groups and with a previously published pass/fail cutoff.Results: Sixteen novices, 13 board-certified specialists in anaesthesiology, and 13 endovascular experts participated. Before training, the anaesthesiologists outperformed the novices by 30 percentage points of the maximum REBOA-RATE score (56% (SD 14.0) vs 26% (SD 17%), p < 0.01). After training, there was no difference in skills between the two groups (78% (SD 11%) vs 78 (SD 14%), p = 0.93). Neither group reached the endovascular experts' skill level (89% (SD 7%), p < 0.05).Conclusion: For doctors mastering the Seldinger technique, there was an initial inter-procedural transfer of skills advantage when performing REBOA. However, after identical simulation-based training, novices performed equally well to anaesthesiologists, indicating that vascular access experience is not a prerequi-site to learning the technical aspects of REBOA. Both groups would need more training to reach technical proficiency.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Anestesi och intensivvård (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Anesthesiology and Intensive Care (hsv//eng)
Nyckelord
- Resuscitative Endovascular Balloon
- Occlusion of the Aorta (REBOA)
- Vascular access Assessment tool
- Skills
- Clinical Competence
- Validity evidence
- Simulation
- Clinical Competence
- Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA)
- Simulation
- Skills
- Validity evidence
- Vascular access, Assessment tool
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Engberg, Morten
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Mikkelsen, Soren
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Hörer, Tal M., 1 ...
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Lindgren, Hans
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Søvik, Edmund
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Frendø, Martin
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Svendsen, Morten ...
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Lönn, Lars
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Konge, Lars
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Russell, Lene
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Taudorf, Mikkel
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Örebro universitet
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