A porcine model for instruction of lateral canthotomy

Objectives: Retrobulbar hemorrhage is a rare condition often necessitating immediate lateral canthotomy for preservation of vision. It is performed in frequently in emergency departments (EDs); therefore, a laboratory-based cu rriculum using a swine model was developed to teach emergency medicine (EM) residents and pediatric emergency medicine (PEM) fellows the proper techni que of lateral canthotomy and to provide them with hands-on training. Metho ds: Anesthetized adult swine are used due to similarity with human anatomy and availability from other concurrent procedure laboratories. Fifteen to t wenty milliliters of saline is injected behind the orbit to produce proptos is and mimic retrobulbar hemorrhage. A dissection is performed on one orbit to demonstrate the technique and to illustrate the lateral canthal ligamen ts. The resident then performs a rapid lateral canthotomy on the contralate ral orbit under faculty supervision. Results: Over one year, 19 EM resident s and 3 PEM fellows were trained using this model. During the same period n o lateral canthotomies were performed in the EDs. A post-laboratory survey demonstrated a high subjective level of comfort with this procedure. Video- based demonstration of this laboratory is publicly available on the World W ide Web. Conclusion: Adult swine can effectively serve as a model for resid ent training in lateral canthotomy, a rarely performed sight-saving procedu re.