Hand & Wrist Injection Trainer (With Tablet)

• Facilitates injection in five key sites of the hand and wrist
• Presence of the Median Nerve allows for negative feedback
• App provides interactive real-time feedback
• Each site can withstand extensive repeated injections
• Skin can be easily removed and changed
• Interactive model anatomy

• Interactive model anatomy
• Anatomically accurate male adult
• Includes important ligament and skeletal structures

• Lightweight and easily portable
• Can be used alongside a simulated patient for communication training
• App can be set to English UK, English USA, French, Mandarin, Spanish and German

Injection Sites

• Carpal Tunnel
• De Quervain’s Sheath
• Trigger Finger
• First Carpometacarpal Joint
• Distal Radioulnar Joint
• Median Nerve

Internal Product Anatomy:

• Palmaris Longus
• Flexor Carpi Radialis
• Extensor Digitorum Group
• Extensor Digiti Minimi
• Abductor Pollicus Longus
• Extensor Pollicus Brevis
• Extensor Pollicus Longus
• Trigger finger nodule (palpation guide)

Bone structures:

• Radial Styloid
• Ulnar Styloid
• Trapezius and Scaphoid
• First Carpometacarpal Joint space
• Distal Radioulnar Joint space
• Lister’s tubercle

• Can be cleaned by wiping with soap and water

• Fluid should not be injected into any of the sites
• Take care when cleaning trainer as electronics are present
• This trainer is latex free

Recommendations for Clinical Skills Curricula for Undergraduate Medical Education, Association of American Medical Colleges, 2008, Appendix B; Clinical Testing and Procedural Skills, p.26 Perform and describe systematic examination of major joints including inspection, palpation, range of motion, and identification of important anatomical landmarks Recommendations for Clinical Skills Curricula for Undergraduate Medical Education, Association of American Medical Colleges, 2005, Appendix B; Clinical Testing and Procedural Skills, p.23 Testing & Procedure Skills: Joint Aspiration Technique; Joint Fluid Examination” Procedural skills: What’s taught in medical school, what ought to be? SR Turner, J Hanson, CJ de Gara, Non-AAMC Recommended: Joint aspiration – % of Schools That Teach – 88%

http://mahec.net/?/residency-and-student-info/residency-program/family-medicine-asheville/our-curriculum Diagnose and stabilize common musculoskeletal trauma and sports injuries, and inject soft tissues and joints; Gain procedural skills (shoulder and knee injections, aspirations…)

ACGME Program Requirements for Graduate Medical Education in Pain Medicine (Anesthesiology, Neurology, or Physical Medicine and Rehabilitation), Accreditation council for Graduate Medical Education, effective 2017, p.17 IV.A.5.b).(4).(j) joint and bursal injections, including sacroiliac, hip, knee, and shoulder joint injections;

ACGME Program Requirements for Graduate Medical Education in Physical Medicine and Rehabilitation, Accreditation council for Graduate Medical Education, effective 2017, p.17 IV.A.5.a).(2).(a) must demonstrate competence in the: performance of therapeutic and diagnostic injections. ACGME Case Log Entry System, Review Committee for Physical Medicine and Rehabilitation, 2014 Peripheral joint/intra-articular injection – (use for small, medium OR major joints, including hip) Peripheral nerve injection (such as suprascapular, infrapatellar,etc.) Ultrasound guidance for needle placement

The Orthopaedic Surgery Milestones Project, A Joint Initiative of The Accreditation Council for Graduate Medical Education and The American Board of Orthopaedic Surgery, July 2015, p.35 Performs simple shoulder procedures (e.g., subacromial injection)

Core Curriculum Outline, for Rheumatology Fellowship Programs, American College of Rheumatology, 2015, p 16 and p 85 Demonstrate competence in arthrocentesis, joint and soft tissue injections. Perform procedures including arthrocentesis and joint and soft tissue injections with ultrasound guidance, when appropriate and feasible.

ACGME Program Requirements for Graduate Medical Education in Musculoskeletal Radiology Accreditation council for Graduate Medical Education, effective 2017, p.2 supervised experience in the application and interpretation of all imaging examinations and procedures as they relate to the analysis of disorders of the musculoskeletal system, including bones, joints, and soft tissues. The imaging methods and procedures include …. diagnostic and therapeutic injections …

Nurse Practitioner (NP) and Physician Assistant (PA) Rheumatology Curriculum Outline, American College of Rheumatology (ACR) and Association of Rheumatology Health Professionals (ARHP), 2017, p.8 Perform procedures, as agreed upon by the supervising/collaborating rheumatologist and NP/PA: 2. Joint and soft tissue injections (adult) a. Indications and contraindications b. Large and medium joints (i.e., knee) c. Trigger points d. Greater trochanteric bursae e. Subacromial space

PAs and OPAs, The Distinctions, American Academy of Pas, 2016, p.5 Joint Injections Physician Assistant – Yes

University of Otago Clinical Skills in the Undergraduate Medical Curriculum, 2013; p.27 Joint injection/aspiration – knows how to do… by the end of the Trainee Intern year

Australian Curriculum Framework for Junior Doctors, Confederation of Postgraduate Medical Education Councils, version 2.2, p.1 Doctors should be able to provide safe treatment to patients through competently performing … Joint aspiration or injection)

Rheumatology Advanced Training Curriculum, Royal Australasian College of Physicians, 2013, p.8 be competent in the use of appropriate diagnostic and therapeutic procedures, including joint and soft tissue injection and aspiration

ACSEP CURRICULUM, Australasian College of Sports and Exercise Physicians, 2017 Demonstrate proficient and appropriate use of procedural skills, both diagnostic and therapeutic. Assessment: Direct Observation of Procedural Skills (DOPS): • Subacromial joint space injection • Acromioclavicular joint injection

2014 RANZCR. Radiodiagnosis Training Program – Curriculum Version 2.1 Musculoskeletal Imaging – Clinical Conditions Category 3 (= useful to know): Arthrography and joint aspiration

RAGCP Lifelong Learning Curriculum: Appropriate Procedures (2016) Guided and unguided musculoskeletal injections (eg trigger point, joint, bursal, intra-articular, carpal tunnel, nerve blocks)

Specialty Training Curriculum for Core Medical Training, Joint Royal Colleges of Physicians Training Board, August 2009, p 92-93 The trainee will be able to assess a patient presenting with joint pain or swelling to produce a valid differential diagnosis, investigate appropriately, formulate and implement a management plan. Knowledge: Recall the generic anatomy of the different types of joint Differentiate between mono-, oligo-, and polyarthritis and recall principal causes for each Recall treatment options for acute arthritides e.g. analgesia, NSAIDs, steroids, physiotherapy etc Skills: Perform a competent physical examination of the musculo-skeletal system Elicit and interpret extra-articular signs of joint disease Order, interpret and act on initial investigations appropriately: blood tests, radiographs, joint aspiration, cultures Make basic interpretation of plain radiographs of swollen joints Practise safe prescribing of analgesics and NSAIDs for joint disease Arranges timely joint aspiration when appropriate to rule out septic cause

Specialty Training Curriculum for Rheumatology, Joint Royal Colleges of Physicians Training Board, 2010, p.17 and 24 Regional Musculoskeletal Examination – Identifying and Interpreting Abnormalities Shoulder Pathology: The trainee should be able to identify: • Rotator cuff lesions • Glenohumeral/capsular pathology • Muscle wasting, proximal myopathy (deltoid) • S/C joint pathology – synovitis • A/C joint pathology – synovitis • Shoulder pain due to pain referred from viscera or neck 5. Practical Procedures: To be able to: Identify, in a given patient, the need for: • Joint aspiration and/or injection with corticosteroid and/or local anaesthetic • Soft tissue injection with corticosteroid and/or local anaesthetic • Aspirate and inject joints competently using the appropriate techniques • Recognise the macroscopic appearance of normal and abnormal synovial fluid (non-inflammatory, inflammatory, haemorrhagic and septic) • Identify synovial fluid crystals on polarised microscopy Competency is required in all of the following core procedures: Shoulder: Joint: Glenohumeral joint, ACJ. Soft tissue: Sub-acromial bursa. The following procedures are optional: Suprascapular nerve block The following procedures are optional: • Ultra-sound guided injections

Specialist Training in Trauma and Orthopaedics Curriculum, British Orthopaedic Association, 2015 (Updated 2018), p.43 SHOULDER Diagnostic and guided injections Trauma & Orthopaedic Curriculum Mapped to Simulation Options, British Orthopaedic Association, 2013, p.62

Specialty Training Curriculum for Sport and Exercise Medicine, Joint Royal Colleges of Physicians Training Board, August 2010, p.53 Skills (mandatory): Safely inject major joints including shoulder, elbow, knee and ankle

The RCGP Curriculum: Professional & Clinical Modules, The Royal College of General Practitioners, 2016, p.327 You may also consider attending courses offering joint injection training.

Speciality Training Curriculum for Clinical Radiology, 2016, p.111 Level 1 Musculoskeletal Training includes Therapeutic joint and soft tissue injections,

• Weight: 3 kg
• Width: 26 cm
• Height: 18 cm
• Length: 52 cm