41 - Clarity, Consistency, and Continuity: A Longitudinal Study of Optimal Embalming Techniques for High Fidelity Ultrasonography Skills Training in Regional Anesthesia

Poster Board Number: 41
There are separate poster presentation times for odd and even posters.
Odd poster #s – first hour
Even poster #s – second hour

Co-authors:

Sorin Darie - Education Program in Anatomy - McMaster University; Gyuah Kim - Education Program in Anatomy - McMaster University; Darren De SA - Assistant Professor, Department of Surgery, McMaster University; Nancy Paris Rosen - Education Program in Anatomy - McMaster University; James Bowness - Consultant Anaesthetist, Nuffield Department of Clinical Neurosciences, University of Oxford; Andrew Palombella - Anatomical Technician, Education Program in Anatomy, McMaster University; Brooke DeCarlo - Anatomical Technician, Education Program in Anatomy, McMaster University; Emily Grant - Education Program in Anatomy - McMaster University; Mauricio Forero - Professor, Department of Anaesthesia, McMaster University; Akil Siva - Assistant Clinical Professor, Department of Medicine, McMaster University; Bruce Wainman - Director, Education Program in Anatomy, McMaster University; Danielle Brewer-Deluce - Assistant Professor, Education Program in Anatomy, McMaster University

Abstract Body : Introduction and Objective:

Soft-embalmed human donors are used for procedure training in ultrasound (US)-guided regional anesthesia. High quality sonograms are important for conducting complex procedures but are highly dependent upon tissue echogenicity. Critically, tissue properties vary based on embalming solutions, but there have been no comparisons of sonographic quality in tissues embalmed with different solutions across regions of interest, and there are no studies reporting on image quality changes over time. This study thus aims to 1) compare the sonographic quality of tissues preserved with two common, high-performing embalming solutions at key clinical sites and 2) observe changes in sonographic quality over four months.



Materials and Methods:

Six human bodies will be embalmed with either a Saturated Salt Solution (SSS, n=3) or an Ethanol-Phenol solution (EP, n=3). Sonograms will be obtained by two anesthetists blinded to the embalming solution, using a GE Logiq P5 Ultrasound machine. Sonograms will be acquired ipsilaterally in seven common nerve block sites, following a standardized protocol. Imaging and evaluation will occur immediately before and after embalming, and at one-, two-, and four-months post-embalming.



Results:

Throughout the study, 1260 sonograms (3 per site) will be collected. Sonograms will be examined for image quality, resolution, detail, and clinical interpretability using the ScanNav™ Anatomy Peripheral Nerve Block artificial intelligence (AI) device and by experts blinded to tissues preparation. A modified version of the McMaster Embalming Scale will also be used to quantify visual/tactile information regarding tissue realism. Data analysis will be conducted using MANOVA. AI acquired metrics will be compared against human-expert evaluators as a control, and then between embalming solutions and across scanning sites, as well as longitudinally to evaluate temporal change.



Conclusion:

Results of this study will quantify the effectiveness of SSS and EP solutions for US-guided regional anaesthesiology in seven anatomical regions critical to resident training.



Significance and Implication:

Overall, identifying the comparative ability of embalming solutions to preserve sonographic image fidelity is a key step forward in optimizing the many practical aspects necessary for efficacious post-graduate medical skills training and for optimal use of body donors. Specifically, it allows for the use of better models in resident training sessions, the streamlining of embalming methods in laboratories, the efficient use of donated bodies, and the opportunity to standardize comparisons against new solutions and techniques.