1. Introduction Pilot Study: The Use of Cadaver Models to Diagnose Rib Fractures PI: Josh Greenstein, MD Co-Investigators: Josie Acuna, MD, Monica Kapoor, MD, RDMS, Cara Brown, MD, RDMS, Lea Salazar, MD, Abbas Husain, MD, Devjani Das, MD, RDMS, FACEP Staten Island University Hospital There are a limited number of studies evaluating the use of cadaver models for ultrasound education. Purpose: To determine if emergency medicine (EM) physicians can accurately diagnose rib fractures on cadaver models using bedside ultrasonography. We hypothesized that EM physicians could accurately utilize bedside ultrasound to diagnose rib fractures in cadaver models.

2. Pilot Study: The Use of Cadaver Models to Diagnose Rib Fractures PI: Josh Greenstein, MD Co-Investigators: Josie Acuna, MD, Monica Kapoor, MD, RDMS, Cara Brown, MD, RDMS, Lea Salazar, MD, Abbas Husain, MD, Devjani Das, MD, RDMS, FACEP Staten Island University Hospital This study took place at Northwell Health Bioskills Center Four cadaver models had a designated number of normal and fractured ribs. Prior to ultrasound examination, study investigators fractured a select number of ribs on four cadaver models. Methods

3. Pilot Study: The Use of Cadaver Models to Diagnose Rib Fractures PI: Josh Greenstein, MD Co-Investigators: Josie Acuna, MD, Monica Kapoor, MD, RDMS, Cara Brown, MD, RDMS, Lea Salazar, MD, Abbas Husain, MD, Devjani Das, MD, RDMS, FACEP Staten Island University Hospital Four blinded EM physicians then used ultrasonography to identify either normal or fractured ribs in each of the cadaver models. All of the blinded physicians have completed postgraduate training in emergency ultrasonography. The physicians indicated whether the cadaver models had rib fracture(s); did not have rib fracture(s); was equivocal for rib fracture(s); or if the rib was not visualized. Methods Rib Fracture

4. Pilot Study: The Use of Cadaver Models to Diagnose Rib Fractures PI: Josh Greenstein, MD Co-Investigators: Josie Acuna, MD, Monica Kapoor, MD, RDMS, Cara Brown, MD, RDMS, Lea Salazar, MD, Abbas Husain, MD, Devjani Das, MD, RDMS, FACEP Staten Island University Hospital Results

5. Pilot Study: The Use of Cadaver Models to Diagnose Rib Fractures PI: Josh Greenstein, MD Co-Investigators: Josie Acuna, MD, Monica Kapoor, MD, RDMS, Cara Brown, MD, RDMS, Lea Salazar, MD, Abbas Husain, MD, Devjani Das, MD, RDMS, FACEP Staten Island University Hospital In this study, blinded sonographers were not able to detect rib fractures more than 50% of the time In this small study, it appears that cadaver models would not be a useful teaching modality for diagnosing rib fractures using bedside ultrasound. Conclusions

6. References Pilot Study: The Use of Cadaver Models to Diagnose Rib Fractures PI: Josh Greenstein, MD Co-Investigators: Josie Acuna, MD, Monica Kapoor, MD, RDMS, Cara Brown, MD, RDMS, Lea Salazar, MD, Abbas Husain, MD, Devjani Das, MD, RDMS, FACEP Staten Island University Hospital Special thanks to: Chan, Stewart S. "Emergency Bedside Ultrasound for the Diagnosis of Rib Fractures." The American Journal of Emergency Griffith JF, Rainer TH, Ching AS, Law KL, Cocks RA, Metreweli C. Sonography compared with radiography in revealing acute rib fracture. AJR Am J Roentgenol,1999;173(6):1603-9. Rainer TH, Griffith JF, Lam E, Lam PK, Metreweli C. Comparison of thoracic ultrasound, clinical acumen, and radiography in patients with minor chest injury. J Trauma, 2004; 56(6): 1211-3 Northwell Health Bioskills Education Center