Ultrasound-guided regional anaesthesia is the future - and yet...

eZono's Cue Cards reduce the pain points

As you learn faster and deploy sonography, your clinic saves cost

Ultrasound-guided regional anaesthesia is the future - and yet...

There is wide spread agreement that the ultrasound-guidance in regional anaesthesia (RA) and vascular access (VA) is the future as success rates are significantly increased. In both cases the literature reports success rates increasing from ~70% to over 90%.

This is because for current methods, i.e. nerve stimulation for RA and landmark methods for VA, the clinician is blind to existing anatomy and needle paths in the body. Whereas ultrasound allows real time visualization of anatomy, needle paths, and the spread of anaesthetic.

For RA, not only are success rates increased but also procedures are less painful and analgesia is more effective. 

Thus costs for hospitals are significantly reduced, for example in Germany each minute in an operating theatre costs €10 a failed RA block can cost an extra 15 to 30 minutes of time. Furthermore, the risks for patients and procedural discomfort is significantly reduced.

Thus the penetration of ultrasound use in anaesthesia is growing rapidly; in 2000 less than 2% of German clinicians used ultrasound whereas today close to 20%. The main barrier to faster growth is the long learning curve required.

• back to top
• bottom

---

Training is the pain point

In order to successfully deploy ultrasound-guided regional anaesthesia and vascular access, the user needs to familiarize him/herself with the specifics of sonography, anatomical details in order to interpret sonomorphology and the pharmacology of the local anaesthetic. For vascular access the user needs to deploy the Seldinger technique. Thus the required know-how is broad and can be broken down into the following blocks:

• Sonography know-how
  physics of sound (acoustics, waves, image generation)
  artefacts
  system know-how
  
  
• Anatomy and Sonomorphology
  of examination area and/or the organs
  anatomical variations
  pathology
  display of the needle for invasive techniques


• Application
  optimal patient position
  position of the probe and navigating the probe
  recognizing the first position marks to the target area
  injection and punctuation techniques


• Pharmacology of the local anaesthetic
  indication, contra indication, side effects
  reaction to complications of local anaesthesia

All those information are usually taught in workshops and can be read in medical publications. However, in order to improve the effectiveness of training, practical education is absolutely necessary. In most hospitals this constant learning is very difficult even if there is a resident expert because he has little time to spare. Thus in daily operations ‘learning by doing' has become the norm.

The learning curve is determined by the individual's skill set and more importantly by the number of procedures done. The challenge in anaesthesia in particular is the large amount of potential applications but the low number of procedures per application in a given period. This provides a challenging learning curve. Exactly here lies the groundbreaking value of eZono's Cue Cards and pre-sets:

• back to top
• bottom

---

eZono's Cue Cards reduce the pain points

Our revolutionary Cue Cards is an interactive anaesthesia specific module for training. The Cue Cards are accompanied for application specific imaging pre-sets to facilitate the use of our portable ultrasound system.

The Cue Card system guides you step by step through the most common regional anesthesia procedures:

• Interscalene
• Supraclavicular
• Axillary
• Intercostal
• Femoral
• Proxi-mal sciatic
• Distal sciatic
  

Additionally the following vascular access are also implemented:

• Internal jugular
• Axillary
• Femoral
  

Choose the procedure from an easy-to-understand multi-media menu and the system guides you through the procedure via 3D anatomical maps and videos and for instance shows you how to position the patient and the probe. It follows a six step process for each of those applications mentioned above:

• Choose procedure
• Patient position
• Navigation
• Target
• Needling
• Tips & Tricks

You can check the real-time image against our reference images and videos, so you always know what you should see on the screen. We focused in particular on anatomical navigation points in the 3D maps, so you always find the right starting point for your procedure. On top of this, we provide tips & tricks for every procedure like the typical complications ("CAVE") or catheter techniques. All this is readily available and accessible via an intuitive touch screen graphical menu. No need to search for buttons here as well. But most important it is there when you need it: during the actual procedure or when you have a spare 5 minutes for practise in real-time.

With all this information embedded, the system allows you to

• Standardize workflow and image interpretation
• Accelerate the learning curve on nerve blocks & vascular access
• Enhance patient education
• Increase the effectiveness of nerve blocks and reduces complication risks

• back to top
• bottom

---

As you learn faster and deploy sonography, your clinic saves cost

Training on ultrasound is an expensive cost item which has inhibited the spread of sono-guided regional anaesthesia. Thanks to Cue Cards, the learning curve accelerates and thus cost is directly saved not only by faster training but also due to a wider proliferation of sonography in regional anaesthesia. The advantages of sono-guided regional anaesthesia are significant in this regards

• Lower cost compared to general anaesthesia
• Reduced complication risk (i.e. nerve injury, pneumothorax, hematomas, multiple punctuations)
• Saving time in vascular access
• Reducing the dose of anaesthetic
• Combining catheter technique for operation and post operation pain therapy by applying varying doses of anaesthetic
• User for patient with neuropathology (Diabetes mellitus) where nerve stimulation does not work
• Higher success rates compared with nerve stimulation methods traditionally used in regional anaesthesia
  

Thus the return on investment on an eZono 3000 is stark and fast. Furthermore the eZono 3000's value is enhanced by the ability to use it across disciplines (intensive care, pain therapy, emergency care). The value of Cue Cards also does not decline over time as young assistant doctors have to be trained in sono-guided regional anaesthesia when they rotate into the department.

Most importantly: patients are more satisfied.

For more information on the return on investment of our eZono 3000
contact us here.

• back to top
• bottom