A porcine model for instruction of lateral canthotomy.
OBJECTIVE
Retrobulbar hemorrhage is a rare condition often necessitating immediate lateral canthotomy for preservation of vision. It is performed infrequently in emergency departments (EDs); therefore, a laboratory-based curriculum using a swine model was developed to teach emergency medicine (EM) residents and pediatric emergency medicine (PEM) fellows the proper technique of lateral canthotomy and to provide them with hands-on training.


METHODS
Anesthetized adult swine are used due to similarity with human anatomy and availability from other concurrent procedure laboratories. Fifteen to twenty milliliters of saline is injected behind the orbit to produce proptosis and mimic retrobulbar hemorrhage. A dissection is performed on one orbit to demonstrate the technique and to illustrate the lateral canthal ligaments. The resident then performs a rapid lateral canthotomy on the contralateral orbit under faculty supervision.


RESULTS
Over one year, 19 EM residents and 3 PEM fellows were trained using this model. During the same period no lateral canthotomies were performed in the EDs. A post-laboratory survey demonstrated a high subjective level of comfort with this procedure. Video-based demonstration of this laboratory is publicly available on the World Wide Web.


CONCLUSIONS
Adult swine can effectively serve as a model for resident training in lateral canthotomy, a rarely performed sight-saving procedure.
Department of Emergency Medicine, Rhode Island Hospital, Brown University School of Medicine, Providence 02903, USA. selim_suner@brown.edu
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Suner
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Simmons
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Savitt
D000818:Animals; D002983:Clinical Competence; D003479:Curriculum; D004503:Education, Medical, Graduate; D004635:Emergency Medicine / Q000193:education* / Q000379:methods; D005260:Female; D007396:Internship and Residency; D023421:Models, Animal; D013508:Ophthalmologic Surgical Procedures / Q000379:methods*; D019315:Retrobulbar Hemorrhage / Q000601:surgery*; D013552:Swine; D014481:United States