Development of a Novel Ultrasound-guided Peritonsillar Abscess Model for Simulation Training
Introduction Peritonsillar abscess (PTA) is the most common deep space infection of the head and neck presenting to emergency departments. 1 No commercial PTA task trainer exists for simulation training. Thus, resident physicians often perform their first PTA needle aspiration in the clinical settin...
| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
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eScholarship Publishing, University of California
2017-12-01
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| Series: | Western Journal of Emergency Medicine |
| Online Access: | https://escholarship.org/uc/item/91h389p3 |
| _version_ | 1828488541216178176 |
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| author | Vivienne Ng Jennifer Plitt David Biffar |
| author_facet | Vivienne Ng Jennifer Plitt David Biffar |
| author_sort | Vivienne Ng |
| collection | DOAJ |
| description | Introduction Peritonsillar abscess (PTA) is the most common deep space infection of the head and neck presenting to emergency departments. 1 No commercial PTA task trainer exists for simulation training. Thus, resident physicians often perform their first PTA needle aspiration in the clinical setting, knowing that carotid artery puncture and hemorrhage are serious and devastating complications. While several low-fidelity PTA task trainers have been previously described, none allow for ultrasound image acquisition. 6– 9 We sought to create a cost-effective and realistic task trainer that allows trainees to acquire both diagnostic ultrasound and needle aspiration skills while draining a peritonsillar abscess. Methods We built the task trainer with low-cost, replaceable, and easily cleanable materials. A damaged airway headskin was repurposed to build the model. A mesh wire cylinder attached to a wooden base was fashioned to provide infrastructure. PTAs were simulated with a water and lotion solution inside a water balloon that was glued to the bottom of a paper cup. The balloon was fully submerged with ordnance gelatin to facilitate ultrasound image acquisition, and an asymmetric soft palate and deviated uvula were painted on top after setting. PTA cups were replaced after use. We spent eight hours constructing three task trainers and used 50 PTA cups for a total cost <$110. Results Forty-six emergency medicine (EM) residents performed PTA needle aspirations using the task trainers and were asked to rate ultrasound image realism, task trainer realism, and trainer ease of use on a five-point visual analog scale, with five being very realistic and easy. Sixteen of 46 (35%) residents completed the survey and reported that ultrasound images were representative of real PTAs (mean 3.41). They found the model realistic (mean 3.73) and easy to use (mean 4.08). Residents rated their comfort with the drainage procedure as 2.07 before and 3.64 after practicing on the trainer. Conclusion This low-cost, easy-to-construct simulator allows for ultrasound image acquisition while performing PTA needle aspirations and is the first reported of its kind. Educators from EM and otolaryngology can use this model to educate inexperienced trainees, thus ultimately improving patient safety in the clinical setting. |
| first_indexed | 2024-12-11T10:09:52Z |
| format | Article |
| id | doaj.art-33a6043b41234d3484628202eecfa7a5 |
| institution | Directory Open Access Journal |
| issn | 1936-9018 |
| language | English |
| last_indexed | 2024-12-11T10:09:52Z |
| publishDate | 2017-12-01 |
| publisher | eScholarship Publishing, University of California |
| record_format | Article |
| series | Western Journal of Emergency Medicine |
| spelling | doaj.art-33a6043b41234d3484628202eecfa7a52022-12-22T01:11:46ZengeScholarship Publishing, University of CaliforniaWestern Journal of Emergency Medicine1936-90182017-12-0119110.5811/westjem.2017.11.36427wjem-19-172Development of a Novel Ultrasound-guided Peritonsillar Abscess Model for Simulation TrainingVivienne Ng0Jennifer Plitt1David Biffar2University of Arizona, Department of Emergency Medicine, Tucson, ArizonaUniversity of Arizona, Department of Emergency Medicine, Tucson, ArizonaUniversity of Arizona, Arizona Simulation Technology & Education Center, Tucson, ArizonaIntroduction Peritonsillar abscess (PTA) is the most common deep space infection of the head and neck presenting to emergency departments. 1 No commercial PTA task trainer exists for simulation training. Thus, resident physicians often perform their first PTA needle aspiration in the clinical setting, knowing that carotid artery puncture and hemorrhage are serious and devastating complications. While several low-fidelity PTA task trainers have been previously described, none allow for ultrasound image acquisition. 6– 9 We sought to create a cost-effective and realistic task trainer that allows trainees to acquire both diagnostic ultrasound and needle aspiration skills while draining a peritonsillar abscess. Methods We built the task trainer with low-cost, replaceable, and easily cleanable materials. A damaged airway headskin was repurposed to build the model. A mesh wire cylinder attached to a wooden base was fashioned to provide infrastructure. PTAs were simulated with a water and lotion solution inside a water balloon that was glued to the bottom of a paper cup. The balloon was fully submerged with ordnance gelatin to facilitate ultrasound image acquisition, and an asymmetric soft palate and deviated uvula were painted on top after setting. PTA cups were replaced after use. We spent eight hours constructing three task trainers and used 50 PTA cups for a total cost <$110. Results Forty-six emergency medicine (EM) residents performed PTA needle aspirations using the task trainers and were asked to rate ultrasound image realism, task trainer realism, and trainer ease of use on a five-point visual analog scale, with five being very realistic and easy. Sixteen of 46 (35%) residents completed the survey and reported that ultrasound images were representative of real PTAs (mean 3.41). They found the model realistic (mean 3.73) and easy to use (mean 4.08). Residents rated their comfort with the drainage procedure as 2.07 before and 3.64 after practicing on the trainer. Conclusion This low-cost, easy-to-construct simulator allows for ultrasound image acquisition while performing PTA needle aspirations and is the first reported of its kind. Educators from EM and otolaryngology can use this model to educate inexperienced trainees, thus ultimately improving patient safety in the clinical setting.https://escholarship.org/uc/item/91h389p3 |
| spellingShingle | Vivienne Ng Jennifer Plitt David Biffar Development of a Novel Ultrasound-guided Peritonsillar Abscess Model for Simulation Training Western Journal of Emergency Medicine |
| title | Development of a Novel Ultrasound-guided Peritonsillar Abscess Model for Simulation Training |
| title_full | Development of a Novel Ultrasound-guided Peritonsillar Abscess Model for Simulation Training |
| title_fullStr | Development of a Novel Ultrasound-guided Peritonsillar Abscess Model for Simulation Training |
| title_full_unstemmed | Development of a Novel Ultrasound-guided Peritonsillar Abscess Model for Simulation Training |
| title_short | Development of a Novel Ultrasound-guided Peritonsillar Abscess Model for Simulation Training |
| title_sort | development of a novel ultrasound guided peritonsillar abscess model for simulation training |
| url | https://escholarship.org/uc/item/91h389p3 |
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