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Teaching and Learning Obstetric Epidurals Using 3D Technology on YouTube
Abstract Number: OP1-1
Abstract Type: Case Report/Case Series
The key factor for successful epidural catheter placement is the proper orientation of the needle. Epidural placement can be challenging in the obstetric population due to exaggerated lumbar lordosis and increased body weight, both of which can obscure landmarks. Epidural placements can be particularly difficult in patients with scoliosis given the rotational component associated with spine curvature. The concepts of needle direction in these situations can be difficult to appreciate. Demonstrations using osseous or plastic spine models can be helpful but not always practical at the bedside. Two–dimensional (2D) images of the spine lack depth perception and are not useful for demonstrating needle trajectory. Three-dimensional (3D) technology is best for this purpose. Earlier we used 3D technology to produce 3D videos and conducted a 6-question survey. 92% of trainees felt the 3D videos improved their understanding of epidural anatomy. The average score on the survey improved from 52% before watching the videos to 85% following the videos. The greatest improvement was in CA-1 trainees with minimal epidural placement experience, with an average of 42% improvement.. Unfortunately, the equipment used was very expensive and methodology was very complex. Here, we demonstrate a simple technique to produce 3D scenarios using a conventional 3D digital camera that may have wider teaching implications.
Methods: We used a Fuji 3D HD W3 camera that has two camera channels. The 3D videos produced by this camera can be observed on its 3D screen. They can be also viewed on a 3D-HD screen with polarizing eyewear. Most importantly, we created anaglyph 3D videos that can be seen on conventional iphones, ipads, personal computers (PCs) using inexpensive paper red-cyan filters. We also converted these 3D files into 3D-YouTube formats so that they can be accessed worldwide. The following scenarios on a spine model were recorded in 3D: normal epidural and CSE needle placement, unilateral catheter migration through intervertebral foramina, failed CSE, and epidural placement in lordotic and scoliotic spines. The 3D videos accompanied by commentary are uploaded on YouTube. The videos can be accessed, viewed and downloaded for teaching using devices such as ipads, iphones, and smartphones.
Access: These 3D videos can be accessed and downloaded from YouTube using search criteria; “Failed epidural” in YouTube, or “Failed epidural YouTube” in google.