OVERTON-HARRIS Petter1, Sachi PATEL1, Ian BLANDFORD1, Brion BENNINGER1-9. Medical Anatomy Center1, Departments of Medical Anatomical Sciences2, Neuromuscular Medicine3, Family Practice4, Western University of Health Sciences,... [ view full abstract ]
OVERTON-HARRIS Petter1, Sachi PATEL1, Ian BLANDFORD1, Brion BENNINGER1-9. Medical Anatomy Center1, Departments of Medical Anatomical Sciences2, Neuromuscular Medicine3, Family Practice4, Western University of Health Sciences, COMP–Northwest, Lebanon, OR. USA. Departments of Orthopaedics5, General Surgery6 and Sports Medicine7, Samaritan Health Services, Corvallis, OR. USA. Departments of Surgery8, Orthopaedics & Rehabilitation9, Oregon Health & Science University, Portland, OR. USA
INTRODUCTION. Ultrasound (US) has traditionally been a soft-tissue medium. Recent studies suggest diagnostic use of US identifying fractures. Skull and facial fractures commonly present to Emergency Medicine departments. The objective of this study was to assess whether medical students could identify nasal bone fractures using varied ultrasound probes from donor cadavers. METHODS. Literature search was conducted on US training to identify nasal fractures using variable probes on unembalmed cadavers (UC) for first-year medical students (MS1). Nine UC head & neck specimens were examined (ages 34-85: avg 70, 5F:4M). Twenty MS1 each had nine separate trials (n = 160); 10 performed 80 trials using novel Sonivate Finger Probe (SFP), 10 using a classic linear probe (CLP, 5-12 MHz) on Fukuda Denshi UF-760AG system. Examinees were not provided examples of intact or fractured nasal bones. True-positives (TP), true-negatives (TN), false-positives (FP) and false-negatives (FN) were recorded for the nasal region. Students (13 male, 7 female) were chosen who had previous US experience with limbs and cavities during anatomy lab, but not with bony structures of head and neck regions. RESULTS. Literature search revealed no known studies. Data revealed 71.9% of the 20 students were able to correctly identify the presence or absence of a fracture. Although more TP and TN were identified with the CLP versus the SFP, the difference was not statistically significant (p-value = 0.217). DISCUSSION. Early studies suggest that US can be used diagnostically to identify skull and facial fractures. The value of using US for identifying skull and facial fractures could expedite treatment regimen and reduce overall waiting times in the Emergency Medicine departments. Although a 71.9% success rate of TP and TN is not ideal, the results revealed that US can identify and exclude nasal bone fractures by true novice US users. CONCLUSION. This study suggests that UC can be used successfully as an US training method for medical students, residents, and post-residency positions to identify and exclude nasal fractures using novel finger and classic linear probes.
Use of ultrasound in Undergraduate Medical Education , Use of ultrasound in Graduate Medical and Continuing Education , Point of Care ultrasound in health care delivery to underserved populations
