Ultrasound in Emergency Medicine| Volume 43, ISSUE 4, P683-691, October 2012

Use of Cadaver Models in Point-of-care Emergency Ultrasound Education for Diagnostic Applications



      As the use of bedside emergency ultrasound (US) increases, so does the need for effective US education.


      To determine 1) what pathology can be reliably simulated and identified by US in human cadavers, and 2) feasibility of using cadavers to improve the comfort of emergency medicine (EM) residents with specific US applications.


      This descriptive, cross-sectional survey study assessed utility of cadaver simulation to train EM residents in diagnostic US. First, the following pathologies were simulated in a cadaver: orbital foreign body (FB), retrobulbar (RB) hematoma, bone fracture, joint effusion, and pleural effusion. Second, we assessed residents’ change in comfort level with US after using this cadaver model. Residents were surveyed regarding their comfort level with various US applications. After brief didactic sessions on the study’s US applications, participants attempted to identify the simulated pathology using US. A post-lab survey assessed for change in comfort level after the training.


      Orbital FB, RB hematoma, bone fracture, joint effusion, and pleural effusion were readily modeled in a cadaver in ways typical of a live patient. Twenty-two residents completed the pre- and post-lab surveys. After training with cadavers, residents’ comfort improved significantly for orbital FB and RB hematoma (mean increase 1.6, p<0.001), bone fracture (mean increase 2.12, p<0.001), and joint effusion (1.6, p<0.001); 100% of residents reported that they found US education using cadavers helpful.


      Cadavers can simulate orbital FB, RB hematoma, bone fracture, joint effusion, and pleural effusion, and in our center improved the comfort of residents in identifying all but pleural effusion.


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        • Abuhamad A.Z.
        Ultrasound outreach and the crisis in Haiti.
        J Ultrasound Med. 2010; 29: 673-677
        • Dean A.J.
        • Ku B.S.
        • Zeserson E.M.
        The utility of handheld ultrasound in an austere medical setting in Guatemala after a natural disaster.
        Am J Disaster Med. 2007; 2: 249-256
        • Mazur S.M.
        • Rippey J.
        Transport and use of point-of-care ultrasound by a disaster medical assistance team.
        Prehosp Disaster Med. 2009; 24: 140-144
        • American College of Emergency Physicians
        Emergency ultrasound guidelines.
        Ann Emerg Med. 2009; 53: 550-570
        • DiMaggio P.J.
        • Waer A.L.
        • Desmarais T.J.
        • et al.
        The use of a lightly preserved cadaver and full thickness pig skin to teach technical skills on the surgery clerkship—a response to the economic pressures facing academic medicine today.
        Am J Surg. 2010; 200: 162-166
        • Wadman M.C.
        • Lomneth C.S.
        • Hoffman L.H.
        • Zeger W.G.
        • Lander L.
        • Walker R.A.
        Assessment of a new model for femoral ultrasound-guided central venous access procedural training: a pilot study.
        Acad Emerg Med. 2010; 17: 88-92
        • Friedman Z.
        • You-Ten K.E.
        • Bould M.D.
        • Naik V.
        Teaching lifesaving procedures: the impact of model fidelity on acquisition and transfer of cricothyrotomy skills to performance on cadavers.
        Anesth Analg. 2008; 107: 1663-1669
        • Proano L.
        • Jagminas L.
        • Homan C.S.
        • Reinert S.
        Evaluation of a teaching laboratory using a cadaver model for tube thoracostomy(1).
        J Emerg Med. 2002; 23: 89-95
        • Reed A.B.
        • Crafton C.
        • Giglia J.S.
        • Hutto J.D.
        Back to basics: use of fresh cadavers in vascular surgery training.
        Surgery. 2009; 146 (discussion 762–3): 757-762
        • Frezza E.E.
        • Solis R.L.
        • Silich R.J.
        • Spence R.K.
        • Martin M.
        Competency-based instruction to improve the surgical resident technique and accuracy of the trauma ultrasound.
        Am Surg. 1999; 65: 884-888
        • Delaunoy I.
        • Feipel V.
        • Appelboom T.
        • Hauzeur J.P.
        Sonography detection threshold for knee effusion.
        Clin Rheumatol. 2003; 22: 391-392
        • Hong B.Y.
        • Lim S.H.
        • Cho Y.R.
        • et al.
        Detection of knee effusion by ultrasonography.
        Am J Phys Med Rehabil. 2010; 89: 715-721
        • Stone M.B.
        • Teismann N.A.
        • Wang R.
        Ultrasonographic confirmation of intraosseous needle placement in an adult unembalmed cadaver model.
        Ann Emerg Med. 2007; 49: 515-519
        • Crystal C.S.
        • Masneri D.A.
        • Hellums J.S.
        • et al.
        Bedside ultrasound for the detection of soft tissue foreign bodies: a cadaveric study.
        J Emerg Med. 2009; 36: 377-380
        • Holmes J.F.
        • Panacek E.A.
        • Sakles J.C.
        • Brofeldt B.T.
        Comparison of 2 cricothyrotomy techniques: standard method versus rapid 4-step technique.
        Ann Emerg Med. 1998; 32: 442-446
        • Are C.
        • Stoddard H.A.
        • Northam L.C.
        • Thompson J.S.
        • Todd G.L.
        An experience in surgical anatomy to provide first-year medical students with an early exposure to general surgery: a pilot study.
        J Surg Educ. 2009; 66: 186-189
        • Glasgow S.C.
        • Tiemann D.
        • Frisella M.M.
        • Conroy G.
        • Klingensmith M.E.
        Laparoscopy as an educational and recruiting tool.
        Am J Surg. 2006; 191: 542-544
        • Ma G.
        • Davis D.P.
        • Schmitt J.
        • Vilke G.M.
        • Chan T.C.
        • Hayden S.R.
        The sensitivity and specificity of transcricothyroid ultrasonography to confirm endotracheal tube placement in a cadaver model.
        J Emerg Med. 2007; 32: 405-407