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2018 AAPM&R Meeting in Orlando, Florida>> Three hands on workshops

It was a pleasure to attend the 2018 AAPM&R Meeting in Orlando, Florida this year.  Once again we shared a booth with our distributor, Ambu USA.  We were glad to be there to represent Myoguide injection guidance device as well as demonstrate our new augmented reality toxin injection simulation “Myoguide ARm” prototype.  Myoguide ARm uses an anatomically accurate, lifelike, palpable, arm that can be moved and rotated for injections.

Our “Magic Window” tablet viewer slides on rails over the arm.  The target muscle is selected from a drop down menu.  The muscle is shown superimposed over the lifelike arm and  once confirmed, the simulation is ready to go.  The arm can be palpated to locate the injection site; the syringe and needle syncs under view of the tablet; Once the needle penetrates the arm’s skin, the augmented reality 3D anatomical image is superimposed over the arm.  The “invisibility” button can be pressed on the screen to change the surrounding musculature and surrounding anatomy.  This creates a clear view of the target muscle.  If the needle is on the correct path, the target muscle will turn blue.  Background EMG can be heard once the needle penetrates muscle.  The target muscle turns green when the needle penetrates and insertional EMG is heard to highlight success.   Thanks to all who dropped by to play with this very cool technology.

Myoguide ARm is the first in a series of toxin injection simulations we plan to build.  We will continue to refine this technology and are hopeful these simulations will be adopted to help train clinicians by accurately simulating realistic experiences.  We would love to discuss this new technology with medical schools thinking of adding to their educational programs for new injectors.

This is our 4th year contributing to the hands on workshops.  This year we supported three workshops with Myoguide.  Myoguide is a very useful adjunct to Ultrasound guidance, especially for nerve and endplate location.  Myoguide’s superior stimulation capability includes 0.1mA steps for stimulation pulses for better stimulation location procedures.

Skills Lab 807: Ultrasound Guidance for Chemodenervation Procedures: Upper Limb 

Thursday, October 25, 2018 

2 pm – 5 pm 

Description: This Skills-lab will provide a brief didactic review of the principles of ultrasound for procedural guidance. The remainder of the course will be devoted to hands-on skills acquisition and practice to acquire the skills and technical skills required for ultrasound guided Chemodenervation procedures of key upper limb muscles and peripheral nerves. Attendees will gain key skills in identifying muscles/nerves based on their pattern recognition or appearance when using B-mode ultrasound and critical techniques required for procedural guidance. Hands on procedural practice of in-plane and out of plane needle insertion techniques using ultrasound phantoms will also be provided. 

Faculty: 

Session Director/Moderator: Katharine E. Alter, MD, FAAPMR; Michael C. Munin, MD, FAAPMR 

Hands-On Table Trainer: Stephen A. Nichols, MD; John R. McGuire, MD, FAAPMR; Heakyung Kim, MD, FAAPMR; Rita Ayyangar, MD; Jeffrey S. Brault, DO, FAAPMR; David Cancel, MD, FAAPMR; Monika Desai, MD; Jeimylo C. De Castro, MD, RMSK, DABRM; Franklin S. Domingo, MD, RMSK; Kevin P. Murphy, MD, FAAPMR; 

Faculty: Jeff Strakowski, MD; Atul Patel, MD. 

Equipment Requested: 

• 3 Myoguides – to be used to demonstrate combined ESTIM and Ultrasound Technique 

Skills Lab 815: Ultrasound Guidance for Lower Limb Chemodenvervation Procedures 

Friday, October 26, 2018 

2 pm – 5 pm 

Description: This Skills-lab will provide a brief didactic review of the principles of ultrasound for procedural guidance. The remainder of the course will be devoted to hands-on skills acquisition and practice to acquire the skills and technical skills required for ultrasound guided Chemodenervation procedures of key lower limb muscles and peripheral nerves. Attendees will gain key skills in identifying muscles/nerves based on their pattern recognition or appearance when using B-mode ultrasound and critical techniques required for procedural guidance. Hands on procedural practice of in-plane and out of plane needle insertion techniques using ultrasound phantoms will also be provided. 

Faculty: 

Session Director/Moderator: Katharine E. Alter, MD, FAAPMR 

Hands-On Table Trainer: Rita Ayyangar, MD; Zach Bohart, MD; Jefffrey Brault, DO; David Cancel, MD, FAAPMR; Monika Desai, MD; Jeimylo DeCastro, MD; Franklin S. Domingo, MD, RMSK; Heakyung Kim, MD, FAAPMR; John R. McGuire, MD, FAAPMR 

Faculty: Michael C. Munin, MD 

Equipment Requested: 

• 3 Myoguides 

Skills Lab 819: Ultrasound Guidance for Lower Limb Chemodenervation Procedures: Head and Neck Structures 

Saturday, October 27, 2018

2 pm – 5 pm 

Description: This Skills-lab will provide a brief didactic review of the principles of ultrasound for procedural guidance. The remainder of the course will be devoted to hands-on skills acquisition and practice to acquire the skills and technical skills required for ultrasound guided Chemodenervation procedures of key structures in the head and neck region including glands, muscles and peripheral nerves. Attendees will gain key skills in identifying muscles/nerves based on their pattern recognition or appearance when using B-mode ultrasound and critical techniques required for procedural guidance. Hands on procedural practice of in-plane and out of plane needle insertion techniques using ultrasound phantoms will also be provided. 

Faculty: 

Session Director/Moderator: Katharine E. Alter, MD, FAAPMR 

Hands-On Table Trainer: Zach Bohart, MD; Rita Ayyangar, MD; Jeffrey S. Brault, DO, FAAPMR; David Cancel, MD; Monika Desai, MD; Jeimylo C. De Castro, MD, RMSK, DABRM; Franklin Domingo, MD; John R. McGuire, MD, FAAPMR; Kevin P. Murphy, MD, FAAPMR; Steven Nichols, MD; Ib R. Odderson, MD, PhD, FAAPMR; Atul Patel, MD; 

• Faculty: Heakyung Kim,