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The goal of this project is to use a previously described scoring system - the CIA system - as a teaching tool to help learners assess the bleeding risk of peripheral nerve blocks. We will teach the CIA system to residents, then they will complete a survey in which they apply the system to various peripheral nerve blocks. We hypothesize that the CIA system will allow learners to reach the same consensus about bleeding risk as expert opinions.
Prior survey of Stanford and Palo Alto VA regional anesthesiologists showed diverging assessments of whether various blocks are considered superficial or deep. Investigators hope to have a simple systematic approach to "scoring" regional anesthesia procedures which can be used as a basis for discussion and comparison of regional expert's opinions.
A scoring system using three categories of consideration to classify any regional procedure is proposed. The following three categories, Critical, Intervention, and Assess (CIA) can be used to analyze any procedure to determine bleeding risk. A score of 0 or 1, was given to each parameter depending on whether it was absent or present. A total score can be range from 0 to 3. From this, the risk can be categorized based on the total score as low-risk (0), intermediate-risk (1) or high-risk (2 or 3).
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Residents | We plan to distribute a survey to the Stanford anesthesiology residents to determine their assessment of the bleeding risk of nerve blocks. The survey will list the most common nerve blocks and ask the resident anesthesiologists at Stanford whether the block is low/intermediate/high risk based on a scoring system of location relative to critical structures, compressibility, and whether bleeding or hematoma would be readily apparent. |
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| Attending physicians | We plan to distribute a survey to the Stanford anesthesiology attending physicians to determine their assessment of the bleeding risk of several different nerve blocks. The survey will list the most common nerve blocks and ask Stanford anesthesiologists whether the block is low/intermediate/high risk based on their experience with nerve blocks. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Survey | Other | There will be no interventions for study participants. Participants will be asked to complete a survey. |
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| Measure | Description | Time Frame |
|---|---|---|
| CIA score by trainees | The bleeding risk of each peripheral nerve block as assessed by trainees, using the CIA scoring system. | 2 months |
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Inclusion Criteria:
Exclusion Criteria:
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Stanford Regional Anesthesia attending physicians and residents
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Stanford University | Stanford | California | 94305 | United States |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 31452012 | Background | Tsui BCH, Kirkham K, Kwofie MK, Tran Q, Wong P, Chin KJ, Sondekoppam RV. Practice advisory on the bleeding risks for peripheral nerve and interfascial plane blockade: evidence review and expert consensus. Can J Anaesth. 2019 Nov;66(11):1356-1384. doi: 10.1007/s12630-019-01466-w. Epub 2019 Aug 26. | |
| 29909204 | Background |
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| ID | Term |
|---|---|
| D011795 | Surveys and Questionnaires |
| ID | Term |
|---|---|
| D003625 | Data Collection |
| D004812 | Epidemiologic Methods |
| D008919 | Investigative Techniques |
| D017531 | Health Care Evaluation Mechanisms |
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| Tsui BCH. A systematic approach to scoring bleeding risk in regional anesthesia procedures. J Clin Anesth. 2018 Sep;49:69-70. doi: 10.1016/j.jclinane.2018.06.011. Epub 2018 Jun 15. No abstract available. |
| D011787 | Quality of Health Care |
| D017530 | Health Care Quality, Access, and Evaluation |
| D011634 | Public Health |
| D004778 | Environment and Public Health |