TAVANGARY Fardis1, Petter OVERTON-HARRIS1, Ian BLANDFORD1, Brion BENNINGER1-9. Medical Anatomy Center1, Departments of Medical Anatomical Sciences2, Neuromuscular Medicine3, Family Practice4, Western University of Health... [ view full abstract ]
TAVANGARY Fardis1, Petter OVERTON-HARRIS1, 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. Trauma to the temporal bone commonly presents to the emergency department (ED) and can lead to life-threatening extradural hemorrhage. Given suspicion of an extradural bleed, computed tomography (CT) is the gold-standard. In acute presentations, US could expedite treatment and save lives. The objective of this study was to assess whether medical students could identify temporal bone region fractures using varied ultrasound probes from donor cadavers. METHODS. Literature search was conducted regarding US training to identify temporal bone fractures on unembalmed cadavers (UC) for 1st year medical students (MS1). Nine UC (head & neck) were examined (ages 34-85:avg 70). Twenty MS1 conducted a total of 340 independent trials; 10 performed 170 trials using novel Sonivate Finger Probe (SFP), 10 using classic linear probe (CLP) (5-12 MHz). True-positives (TP), true-negatives (TN), false-positives and false-negatives were recorded for TBF. Students (13M, 7 F) were chosen who had previous US experience with limbs and cavities but no bony structures of the head and neck region. RESULTS. Literature search revealed no known studies. 90.6% of students were able to correctly identify fracture or no fracture. Sensitivity and specificity of detection of the TBF were found to be 90% and 95%, respectively. Although more TP and TN were identified with the finger probe vs the classic linear probe, the difference was not statistically significant (p-value 0.234). DISCUSSION. Plain radiographs and CT imaging are commonly used diagnostic tools for TBF, with the gold-standard being CT. Both require departmental imaging, deliver radiation exposure, and, with CT, a high associated cost. US, however, is safe, cost efficient, and can be conducted in real-time. In order to have a cultural educational shift, training methods should be integrated into medical school curriculum. CONCLUSION. This study suggests that UC can be used successfully as an US training method to identify TBF. This work represents a novel study to provide a clinically relevant tool for medical students, residents, and post-residency positions.
Use of ultrasound in Undergraduate Medical Education , Technology , New Uses
