The CIA Score: a Learner's Tool

Study Overview
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Brief Summary
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The goal of this project is to use a previously described scoring system - the CIA system - as a teaching tool to help learners assess the bleeding risk of peripheral nerve blocks. We will teach the CIA system to residents, then they will complete a survey in which they apply the system to various peripheral nerve blocks. We hypothesize that the CIA system will allow learners to reach the same consensus about bleeding risk as expert opinions.

Detailed Description
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Prior survey of Stanford and Palo Alto VA regional anesthesiologists showed diverging assessments of whether various blocks are considered superficial or deep. Investigators hope to have a simple systematic approach to scoring regional anesthesia procedures which can be used as a basis for discussion and comparison of regional expert's opinions. A scoring system using three categories of consideration to classify any regional procedure is proposed. The following three categories, Critical, Intervention, and Assess (CIA) can be used to analyze any procedure to determine bleeding risk. A score of 0 or 1, was given to each parameter depending on whether it was absent or present. A total score can be range from 0 to 3. From this, the risk can be categorized based on the total score as low-risk (0), intermediate-risk (1) or high-risk (2 or 3).

Official Title
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Critical, Intervention, Assess: Using the CIA System as a Learning Tool to Assess Bleeding Risk in Regional Anesthesia.

Conditions
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Anesthesia, Local

Intervention / Treatment
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* Other: Survey


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Regional Anesthesiologist and interested staff from Stanford Exclusion Criteria: Non-regional anesthesiologists and non-interested staff at Stanford

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Residents<br>We plan to distribute a survey to the Stanford anesthesiology residents to determine their assessment of the bleeding risk of nerve blocks. The survey will list the most common nerve blocks and ask the resident anesthesiologists at Stanford whether the block is low/intermediate/high risk based on a scoring system of location relative to critical structures, compressibility, and whether bleeding or hematoma would be readily apparent. | Other: Survey<br>* There will be no interventions for study participants. Participants will be asked to complete a survey.<br>|
| Attending physicians<br>We plan to distribute a survey to the Stanford anesthesiology attending physicians to determine their assessment of the bleeding risk of several different nerve blocks. The survey will list the most common nerve blocks and ask Stanford anesthesiologists whether the block is low/intermediate/high risk based on their experience with nerve blocks. | Other: Survey<br>* There will be no interventions for study participants. Participants will be asked to complete a survey.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| CIA score by trainees | The bleeding risk of each peripheral nerve block as assessed by trainees, using the CIA scoring system. | 2 months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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regional anesthesia, peripheral nerve block, acute pain medicine