• Anisha Duvvi, Mohammad Ganji, Yasmine Habal, Hebron Bekele, Ceilim Kim, Evan Yates, Shterna Seligson, Greg McWhir, Hossein Kalantari, Jaspreet Singh, and Getaw Worku Hassen.
• Albert Einstein College of Medicine, USA; Metropolitan Hospital Center, Department of Emergency Medicine, USA.
• Am J Emerg Med. 2023 Sep 1; 71: 104108104-108.

BackgroundTraumatic epidural hematoma (EDH) with the potential to displace the brain tissue and increase intracranial pressure (ICP), is a life-threatening condition that requires emergent intervention. In rare circumstances, Emergency Physician (EP) may have to do skull trephination to reduce the ICP as a temporary measure.Specific AimsTo evaluate emergency medicine (EM) residents' comfort in performing emergency department (ED) burr holes and to assess their difficulties and evaluate comfort level before and after simulated EDH cases.Materials And MethodsA 3D-printed skull, electrical and manual drills were used for the simulation. Subjective comfort level pre and post-procedure, as well as objective procedural skills and time to complete the drill, were recorded.ResultsTwenty EM residents participated in the simulation study. The median time to perforate through the skull was 4 s for the electric drill and 10 s for the manual drill. A comfort level of 5 and above was reported by 12 participants for the manual drill and by 17 participants for the electric drill. Six participants had mild and 2 participants had moderate observed difficulty in handling the manual and electric drill. Most participants performed both procedures successfully with one attempt only. Three participants have an overall comfort level above 5 before the simulation and 13 participants had overall comfort level above 5 post-simulation.ConclusionThe 3D-printed model assisted the ED burr hole simulation and the residents could perform the procedure with minimum difficulties.Copyright © 2023. Published by Elsevier Inc.

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