Abstract：
OBJECTIVE: In the Emergency Department (ED), ultrasound-guided nerve blocks (UGNBs) have become a cornerstone of multimodal pain regimens. We investigated current national practices of UGNBs across academic medical center EDs, and how these trends have changed over time.
METHODS: We conducted a cross-sectional electronic survey of academic EDs with ultrasound fellowships across the United States. Twenty-item questionnaires exploring UGNB practice patterns, training, and complications were distributed between November 2021-June 2022. Data was manually curated, and descriptive statistics were performed. The survey results were then compared to results from Amini et al. 2016 UGNB survey to identify trends.
RESULTS: The response rate was 80.5% (87 of 108 programs). One hundred percent of responding programs perform UGNB at their institutions, with 29% (95% confidence interval (CI), 20%-39%) performing at least 5 blocks monthly. Forearm UGNB are most commonly performed (96% of programs (95% CI, 93%-100%)). Pain control for fractures is the most common indication (84%; 95% CI, 76%-91%). Eighty-five percent (95% CI, 77%-92%) of programs report at least 80% of UGNB performed are effective. Eighty-five percent (95% CI, 66%-85%) of programs have had no reported complications from UGNB performed by emergency providers at their institution. The remaining 15% (95% CI, 8%-23%) report an average of 1 complication annually.
CONCLUSIONS: All programs participating in our study report performing UGNB in their ED, which is a 16% increase over the last 5 years. UGNB\'s are currently performed safely and effectively in the ED, however practice improvements can still be made. Creating multi-disciplinary committees at local and national levels can standardize guidelines and practice policies to optimize patient safety and outcomes.
METHODS: We conducted a cross-sectional electronic survey of academic EDs with ultrasound fellowships across the United States. Twenty-item questionnaires exploring UGNB practice patterns, training, and complications were distributed between November 2021-June 2022. Data was manually curated, and descriptive statistics were performed. The survey results were then compared to results from Amini et al. 2016 UGNB survey to identify trends.
RESULTS: The response rate was 80.5% (87 of 108 programs). One hundred percent of responding programs perform UGNB at their institutions, with 29% (95% confidence interval (CI), 20%-39%) performing at least 5 blocks monthly. Forearm UGNB are most commonly performed (96% of programs (95% CI, 93%-100%)). Pain control for fractures is the most common indication (84%; 95% CI, 76%-91%). Eighty-five percent (95% CI, 77%-92%) of programs report at least 80% of UGNB performed are effective. Eighty-five percent (95% CI, 66%-85%) of programs have had no reported complications from UGNB performed by emergency providers at their institution. The remaining 15% (95% CI, 8%-23%) report an average of 1 complication annually.
CONCLUSIONS: All programs participating in our study report performing UGNB in their ED, which is a 16% increase over the last 5 years. UGNB\'s are currently performed safely and effectively in the ED, however practice improvements can still be made. Creating multi-disciplinary committees at local and national levels can standardize guidelines and practice policies to optimize patient safety and outcomes.
摘要：
目标：在急诊科（ED），超声引导下的神经阻滞(UGNBs)已成为多模式疼痛治疗方案的基石.我们调查了UGNB在学术医学中心ED的当前国家实践，以及这些趋势如何随着时间的推移而变化。
方法：我们在美国各地与超声研究金一起对学术ED进行了横断面电子调查。探索UGNB实践模式的20项问卷，培训,并发症分布在2021年11月至2022年6月之间。数据是手动整理的，并进行描述性统计。然后将调查结果与Amini等人的结果进行比较。2016年UGNB调查以确定趋势。
结果：反应率为80.5%（108个项目中有87个）。百分之百的响应程序在他们的机构执行UGNB，29%(95%置信区间(CI)，20%-39%）每月至少执行5个区块。前臂UGNB是最常见的（96％的程序（95％CI，93％-100％））。骨折的疼痛控制是最常见的指征（84％；95％CI，76％-91％）。85%（95%CI，77%-92%）的项目报告至少80%的UGNB是有效的。百分之八十五（95％CI，66％-85％）的计划没有报告由其机构的急诊提供者进行的UGNB并发症。其余15％（95％CI，8％-23％）报告每年平均1次并发症。
结论：参与我们研究的所有项目都报告在其ED中执行UGNB，比过去5年增长了16%。UGNB目前在ED中安全有效地执行，然而，实践仍然可以改进。在地方和国家层面建立多学科委员会可以规范指导方针和实践政策，以优化患者安全和结果。
方法：我们在美国各地与超声研究金一起对学术ED进行了横断面电子调查。探索UGNB实践模式的20项问卷，培训,并发症分布在2021年11月至2022年6月之间。数据是手动整理的，并进行描述性统计。然后将调查结果与Amini等人的结果进行比较。2016年UGNB调查以确定趋势。
结果：反应率为80.5%（108个项目中有87个）。百分之百的响应程序在他们的机构执行UGNB，29%(95%置信区间(CI)，20%-39%）每月至少执行5个区块。前臂UGNB是最常见的（96％的程序（95％CI，93％-100％））。骨折的疼痛控制是最常见的指征（84％；95％CI，76％-91％）。85%（95%CI，77%-92%）的项目报告至少80%的UGNB是有效的。百分之八十五（95％CI，66％-85％）的计划没有报告由其机构的急诊提供者进行的UGNB并发症。其余15％（95％CI，8％-23％）报告每年平均1次并发症。
结论：参与我们研究的所有项目都报告在其ED中执行UGNB，比过去5年增长了16%。UGNB目前在ED中安全有效地执行，然而，实践仍然可以改进。在地方和国家层面建立多学科委员会可以规范指导方针和实践政策，以优化患者安全和结果。
