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The Use of Surface Anatomy in Emergency Interventional Procedures: A Mixed Methods Analysis Comparing the Procedural Approaches of Clinicians

A good knowledge of surface anatomy forms an essential part of safe and effective clinical practice for many healthcare specialties. Understanding and using surface anatomy is key to interpreting normal anatomy on medical images and being able to describe the location, appearance and relationships of palpable anatomical structures. It is the definition of usable anatomy. However, evidence shows that even though clinicians rank surface anatomy as an essential aspect of anatomy needed to succeed in training, the way in which qualified clinicians use surface anatomical landmarks for common procedures varies greatly. This two‐phase sequential explanatory mixed methods study explored how practising emergency medicine and surgical clinicians, at various levels of qualification, use surface anatomy in order to perform a cricothyroidotomy, thoracostomy and/or thoracotomy. It examined what surface anatomy is used, how it is used, why it was used, and explored clinicians' perceptions of the importance of surface anatomy in performing these procedures. Using this case study example, the findings illustrate that inconsistencies exist in the use and application of surface anatomy in practice. It highlights the need to more fully understand how surface anatomy is being used across specialities, across procedures and across levels of training. Finally, this study has shown there is a need for improved applied training in landmarking for core procedures that require a comprehensive knowledge of surface anatomy. Only in understanding the most common misconceptions and inconsistencies in surface anatomy's use and application, can current guidelines help shape future teaching of the subject.