The aims of an USGRA coordinator are based in three principles:

The first one is to define the core competencies and if the trainees can do the blocks. The second one is to establish the way we are going to train the blocks and in which sequence. Finally, we need to find a targeted number of blocks that will guarantee that the trainee is competent in the technique.

But what are the tasks included into these three pillars? From basic knowledge in physics and ultrasound, orientation and needling technique to proper data collection and analysis are essential for a coordinator to successfully train anaesthetists. To know what are the common key aspects of ultrasound and the typical pitfalls during scanning should be part of the introduction into the USGRA techniques.

Several teaching techniques, using of phantom models and anatomy labs plus a series of assessments to guarantee that no harm to the patients is caused. The main problem with some anaesthetists is that they think knowledge comes easy….

Another major problem is the lack of recognition of other specialties, and also the population. Perhaps by adopting the same models used by our colleagues in Radiology, Cardiology, Accidents and Emergencies we will be put at the same level of recognition and our own colleagues. How do we start building a house? We believe that a solid base is much more important than a state of the art roof.

Regarding patient care there are several aspects to take into account. The use of appropriate sedation, together with a gentle scanning technique and appropriate monitoring during the procedure have to be tested by the coordinator before signing a trainee to go “solo”.

Another step to take will be the ability to diagnose the most relevant patterns and the “abnormal” sonoanatomy to a level that will direct the patient towards the appropriate specialist.

Good up-to-date knowledge of the current literature in the specialty is important to demonstrate that the trainee will continue developing even further what is considered standard level of performance by a supervisor. Familiarity with the equipment used, infection control and asepsia, consent and discussion of complication of the technique have to be checked by the USGRA coordinator.

Overall the final aim is to perform effective and safe blocks.

Rafael Blanco

CAR meeting November 2009