Hope you had a Happy 4th! To all those who received patients with an upper extremity that has been burned, fractured, or blown away from all the “legal” fireworks foreplay……
Pain control. Two words. Patient satisfaction. Two more words. Physician satisfaction. Two MORE words. Nerve blocks are the new procedural sedation for many painful procedures we do in the ED. Takes much less resources and time, and provides immediate pain control for however long your anesthetic will work without concern for respiratory distress, hypotension, hypoxia, and… well… death. So why dont we do it more? Well, in a prior post, we have discussed the ins & outs for performing US guided nerve blocks with the help of some of my colleagues, some of whom are mentioned below.
Since we profiled Drs. Mike Stone and Arun Nagdev most recently, and as they are some of the gurus in emergency physician performed US-guided nerve blocks, teaching it all over the world and publishing study after study on this topic, I wanted to highlight a great review article in this month’s issue of The Journal of US in Medicine. It does a great job in reviewing the indications, technique, and pitfalls of US guided interscalene blocks in particular.
Blaivas et al has discussed this as well (as references by the above journal authors in their review). In his study, “patients undergoing shoulder dislocation reduction using US-guided interscalene block spent less time in the ED and required less one-on-one health care provider time compared to those receiving procedural sedation.”
SonoSpot: Topics in Bedside Ultrasound 