{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,7]],"date-time":"2025-11-07T09:15:47Z","timestamp":1762506947970},"reference-count":29,"publisher":"Springer Science and Business Media LLC","issue":"06","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["CJEM"],"published-print":{"date-parts":[[2017,11]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec id=\"S1481803516003924_abs1\" sec-type=\"objectives\">\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>Bier block (BB) is a safe and effective alternative to procedural sedation\n                     for analgesia during forearm fracture reductions, yet remains infrequently used\n                     in the pediatric emergency department (PED). No standardized methods of BB\n                     training have previously been described. The objective of this study was to\n                     determine whether a multimodal instructional course increases comfort with BB\n                     and translates to increased use of this technique.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec id=\"S1481803516003924_abs2\" sec-type=\"methods\">\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>A novel interdisciplinary simulation and Web-based training course was\n                     developed to teach the use of BB for forearm fracture reduction at a tertiary\n                     PED. Participants were surveyed pre-\/post-training, and at 2 and 6 months\n                     regarding their comfort with BB. In parallel, we prospectively assessed the\n                     clinical use of BB for children ages 6 to 18 years requiring closed reduction\n                     of forearm fractures during the 24-month post-course period.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec id=\"S1481803516003924_abs3\" sec-type=\"results\">\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Course participation included 26 physicians and 12 nurses. Survey response\n                     rate was 100%. Course participation increased both comfort (10% pre-training v.\n                     89% post-training, <jats:italic>p<\/jats:italic>&amp;lt;0.001) and the\n                     willingness to use BB (51% pre-training v. 95% post-training,\n                     <jats:italic>p<\/jats:italic>&amp;lt;0.001), an effect sustained at 6 months\n                     post-course (66% and 92%, respectively,\n                     <jats:italic>p<\/jats:italic>&amp;lt;0.001 for both). In clinical practice,\n                     there were no BBs performed prior to course administration. We observed a\n                     consistent and sustained increase in clinical use among the BB-trained\n                     physicians, with 37% of all forearm reductions performed using BB at 24 months\n                     post-course completion.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec id=\"S1481803516003924_abs4\" sec-type=\"conclusions\">\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>A novel combined simulation and Web-based training course increased\n                     comfort and willingness to use BB and was associated with increased use of this\n                     technique for forearm fracture reduction in the PED.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1017\/cem.2016.392","type":"journal-article","created":{"date-parts":[[2016,11,21]],"date-time":"2016-11-21T03:26:45Z","timestamp":1479698805000},"page":"434-440","source":"Crossref","is-referenced-by-count":4,"title":["Simulation and Web-based learning increases utilization of Bier block for\n                  forearm fracture reduction in the pediatric emergency 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