Ergonomic task analysis of ultrasound-guided femoral nerve block: a pilot study.

Study Objective: To apply ergonomic task analysis to the performance of ultrasound-guided (US-guided) femoral nerve block (FNB) in an acute hospital setting. Design: Pilot prospective observational study. Setting: Orthopedic operating room of a regional trauma hospital. Subjects: 15 anesthesiologist...

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Publicado en:Journal of Clinical Anesthesia Vol. 23; no. 1; pp. 35 - 42
Autores principales: Ajmal M, Power S, Smith T, Shorten GD, Ajmal, Muhammad, Power, Susan, Smith, Tim, Shorten, George D
Formato: research Journal Article
Publicado: Elsevier B.V. Feb2011
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Feb2011
      vid: 23
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      pub: Elsevier B.V.
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        10.1016/j.jclinane.2010.06.006
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        atl: Ergonomic task analysis of ultrasound-guided femoral nerve block: a pilot study.
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          Ajmal M
          Power S
          Smith T
          Shorten GD
          Ajmal, Muhammad
          Power, Susan
          Smith, Tim
          Shorten, George D
        affil: Department of Anesthesia and Intensive Care Medicine, Cork University Hospital and University College Cork, Wilton, Cork, Ireland
      sug:
        subj:
          Femoral Nerve Ultrasonography
          Ergonomics
          Nerve Block Methods
          Aged
          Body Height
          Data Analysis, Statistical
          Environment
          Female
          Femur Surgery
          Hip Surgery
          Knee Surgery
          Male
          Middle Age
          Pilot Studies
          Posture
          Questionnaires
          Task Performance and Analysis
          Aged: 65+ years
          Middle Aged: 45-64 years
          Female
          Male
      ab: Study Objective: To apply ergonomic task analysis to the performance of ultrasound-guided (US-guided) femoral nerve block (FNB) in an acute hospital setting. Design: Pilot prospective observational study. Setting: Orthopedic operating room of a regional trauma hospital. Subjects: 15 anesthesiologists of various levels of experience in US-guided FNB (estimated minimum experience < 10 procedures; maximum about 50 procedures, and from basic trainees to consultants); and 15 patients (5 men and 10 women), aged 77 ± 15 (mean ± SD yrs) years. MEASUREMENTS/OBSERVATIONS: A data capture "tool", which was modified from one previously developed for ergonomic study of spinal anesthesia, was studied. Patient, operator, and heterogeneous environmental factors related to ergonomic performance of US-guided FNB were identified. The observation period started immediately before commencement of positioning the patient and ended on completion of perineural injection. Data were acquired using direct observations, photography, and application of a questionnaire. Main Results: The quality of ergonomic performance was generally suboptimal and varied greatly among operators. Eight (experience < 10 procedures) of 15 operators excessively rotated their head, neck, and/or back to visualize the image on the ultrasound machine. Eight operators (experience < 10 procedures) performed the procedure with excessive thoracolumbar flexion. Conclusion: Performance of US-guided FNB presents ergonomic challenges and was suboptimal during most of the procedures observed. Formal training in US-guided peripheral nerve blockade should include reference to ergonomic factors.
      pubtype: Academic Journal
      doctype:
        research
        Journal Article
      ougenre: Article
    language: English
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