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

@entity1 @entity616
STUDY OBJECTIVE: To apply ergonomic task analysis to the performance of ultrasound-guided (US-guided) femoral @entity616 (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 @entity1 (5 @entity1 and 10 @entity1 ), 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. @entity1 , 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 @entity1 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.
