Impact of Communication Delays on Anesthesia Response to Medical Emergencies and Ultrasound-Guided Regional Anesthesia

NCT07675863 | Recruiting

• 1 other identifier: NSH REB File#: 1031380
• Study Type: interventional
• Target: 42
• Locations: 1 country
• Sites: 1

Brief Summary

Hypotheses The investigators hypothesize that a communication delay of 80 seconds compared to no delay will be associated with longer procedural times and decreased quality during brachial plexus block scanning. Secondly, the communication delay will be associated with more errors in treatment and a delay of essential treatments in a medical emergency. Background The near future will see crewed missions in deep space. As the number of people travelling to space increases, so will the chances of traumatic injury and other medical emergencies. Given many changes to body systems in microgravity and the scarcity of equipment and personnel in space, treating medical emergencies is already very difficult. Because most pain medications interfere with cognition, and general anesthesia would be very risky in these conditions, regional anesthesia ('nerve blocks') has been suggested as a less risky alternative. However, nerve blocks are highly specialized skills and responding to medical emergencies in general requires extensive medical training, it is likely that astronauts will require guidance from earth-based physicians. As crews venture deeper into space, the ability of teams to communicate in real time with earth-based medical teams decreases. For missions to the moon, communication delays of 3 to 160 seconds in each direction are expected. In the event of a medical emergency, space crews may require consultation with ground teams. The investigators predict that this communication delay will impact task duration, create opportunities for miscommunication and potentially result in higher rates of complications. Objectives

• Quantify the difference (communication delay versus no delay) in time to identify critical structures while scanning brachial plexus block sonoanatomy and time to essential treatment during a medical emergency.
• Quantify the difference (communication delay versus no delay) in quality and ease of imaging while scanning brachial plexus block sonoanatomy.
• Quantify the difference in completeness of emergency treatment using a composite measure (communication delay versus no delay).
• Describe the challenges and solutions for team functioning and remote mentorship when a communication delay exists. Methods This is a within-subjects, mixed-methods, simulation-based randomized study. Regional anesthesia novices (medical students) and Canadian Armed Forces (CAF) medical technicians or CAF nurses will be recruited and given a 4-hour training session on the basics of brachial plexus blocks and their complications. Participants will be placed in teams of 3, participating in two simulation scenarios. Once the team enters the simulation space, they will be able to ask for assistance from a "remote" team of experts. Teams will be guided through identifying the sonoanatomy for brachial plexus blocks and responding to a complication from placing a peripheral nerve block. Every team will complete both the no communication delay and 80-second communication delay. Teams will be randomly assigned the order in which they perform each condition. Time to "block" (when the participant identifies where they would place the local anesthetic) and time to essential treatments during an emergency will be recorded. Participants will rate the ease of ultrasound image acquisition and ease of communication, while the expert team will rate the quality of the ultrasound images and the ease of communication. Quantitative outcomes will be analyzed using univariate statistics. After the scenario, teams will debrief the scenario with a focus on communication, safe identification of target nerves and their ability to respond to a complication. Transcriptions of the debriefing sessions will be analyzed for themes using qualitative analysis.

Conditions

Regional Anesthesia; Regional Anesthesia Morbidity; Regional Anesthesia Success; Remote Consultation, Teleconsultation

Keywords

Communication delay; Space Medicine

Outcome Measures

Primary Outcomes (2)

• Time to nerve block

  The investigators will measure the time to finish the block, defined as the time from the transducer first touching the patient to when the participant identifies where they would place the local anesthetic.

  Day 1

• Time to medical intervention

  The investigators will also record the time to medical intervention, defined as the time from a change in vital signs until definitive treatment (e.g. epinephrine for anaphylaxis, lipid emulsion for LAST).

  Day 1

Secondary Outcomes (3)

• Ease of image acquisition

  Day 1

• Ease of communication

  Day 1

• Composite emergency medical treatment

  Day 1

Other Outcomes (1)

• Qualitative communication themes

  Day 1

Study Arms (2)

Real-time communication

ACTIVE COMPARATOR

Other: Real-time communication

Delayed communication

EXPERIMENTAL

Other: Delayed communication

Interventions

Real-time communication OTHER

In the no communication delay condition, the treating team of participants and mission control will be connected by real-time video chat. The video chat will be turned on and available once the participants start the scenario. The chat will remain on throughout the scenario.

Real-time communication

Delayed communication OTHER

In the communication delay condition, there will be a 80-second induced delay between each transmission of communication. Both the treating team and mission control can send more than one message at a time, but the minimum delay will be maintained between receiving each individual message. The number and frequency of messages will not be restrained.

Delayed communication

Eligibility Criteria

• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Child (0-17), Adult (18-64), Older Adult (65+)

You may qualify if:

• Medical students from Dalhousie University and Canadian Armed Forces (CAF) medical technicians or nurses at a minimum of Rank Qualification Medical Technician Private

You may not qualify if:

• prior experience and training in regional anesthesia techniques
• visual/auditory impairments that make unmodified video chats difficult

Sponsors & Collaborators

• Nova Scotia Health Authority: lead

Study Sites (1)

Willow Park Armoury

Halifax, Nova Scotia, B3K 5X5, Canada

RECRUITING

Central Study Contacts

Jonathan G Bailey

CONTACT

902-473-4326‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬; jon.bailey@dal.ca

Sharon Amey

CONTACT

902-473-4337; SharonE1.Amey@nshealth.ca

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: SUPPORTIVE CARE
• Intervention Model: CROSSOVER
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Anesthesiologist

Study Record Dates

• First Submitted: June 18, 2026
• First Posted: June 30, 2026
• Study Start: July 11, 2026
• Primary Completion (Estimated): April 15, 2027
• Study Completion (Estimated): April 15, 2027
• Last Updated: June 30, 2026

Record last verified: 2026-06

Data Sharing

• IPD Sharing: Will not share

Locations

CA (1)