Ultrasound-guided nerve blocks are an effective tool for management of traumatic orthopedic
injuries in the emergency department (ED)
[
1
,
2
,
3
]. Specifically, ultrasound-guided forearm nerve blocks are effective for acute hand
injuries
[
4
,
5
,
6
]. Firework blast injuries accounted for 26 000 ED visits from 2006 to 2010, with the
hand being the most frequently injured body part
[
7
,
8
]. Hand blast injuries involve burns, lacerations, complex soft tissue and ligamentous
injury, or amputation
[
9
,
10
,
11
]. Analgesia, antibiotics, immobilization, hemorrhage control, and orthopedic consultation
are the foundation of ED management
[
12
,
13
]. Ultrasound-guided forearm nerve blocks are an effective adjuvant to a multimodal
ED pain management strategy for these injuries, especially in situations involving
delays to operative management (eg, busy holidays, multicasualty incidents, limited
surgical staff/facilities).To read this article in full you will need to make a payment
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References
- Door-to-block time: prioritizing acute pain management for femoral fractures in the ED.Am J Emerg Med. 2014; 32: 801-803
- Femoral nerve block for diaphyseal and distal femoral fractures in the emergency department.J Bone Joint Surg Am. 2007; 89: 2599-2603
- Ultrasound-guided supraclavicular block for the treatment of upper extremity fractures, dislocations, and abscesses in the ED.Am J Emerg Med. 2006; 25: 472-475
- Feasibility of forearm ultrasonography-guided nerve blocks of the radial, ulnar, and median nerves for hand procedures in the emergency department.Ann Emerg Med. 2006; 48: 558-562
- Ultrasound-guided forearm nerve blocks in kids: a novel method for pain control in the treatment of hand-injured pediatric patients in the emergency department.Pediatr Emerg Care. 2015; 31: 225-259
- Forearm ultrasound–guided nerve blocks vs landmark-based wrist blocks for hand anesthesia in healthy volunteers.Am J Emerg Med. 2016; 34: 730-734
- US emergency department visits for firework injuries, 2006-2010.J Surg Res. 2014; 190: 305-311
- The epidemiology of firework-related injuries in the United States: 2000-2010.Injury. 2014; 45: 1704-1709
- Treatment of blast injuries of the hand.Chir Main. 2004; 23: 215-223
- Explosion injuries of the hand: spatial relationship and injury pattern.J Hand Surg Br. 1996; 21B: 785-787
- Patterns in blast injuries to the hand.Hand. 2009; 4: 44-49
- Treatment of blast injuries of the extremity.J Am Acad Orthop Surg. 2006; 14: S77-S81
- Firework-related injuries of the hand.J Hand Surg Am. 2015; 40: 383-387
- Anesthesia implications of blast injury.J Cardiothorac Vasc Anesth. 2006; 20: 872-880
- Safety in pediatric regional anesthesia.Pediatr Anesth. 2012; 22: 25-30
- Are peripheral and neuraxial blocks with ultrasound guidance more effective and safe in children?.Pediatr Anesth. 2009; 19: 92-96
- Ultrasonographic guidance improves sensory block and onset time of three-in-one blocks.Anesth Analg. 1997; 85: 854-857
- Ultrasonographic guidance reduces the amount of local anesthetic for 3-in-1 blocks.Reg Anesth Pain Med. 1998; 23: 584-588
- Pain control in disaster settings: a role for ultrasound-guided nerve blocks.Ann Emerg Med. 2013; 61: 690-696
- Blast injuries.Lancet. 2009; 374: 405-415
- The American Society of Regional Anesthesia and Pain Medicine, the European Society of Regional Anaesthesia and Pain Therapy, and the Asian Australasian Federation of Pain Societies Joint Committee recommendations for education and training in ultrasound-guided interventional pain procedures.Reg Anesth Pain Med. 2012; 37: 657-664
Article Info
Publication History
Published online: July 11, 2016
Accepted:
June 23,
2016
Received in revised form:
June 23,
2016
Received:
June 2,
2016
Footnotes
☆Consent: Patient details were removed from this report where possible. All patients provided consent for the use of their de-identified information.
Identification
Copyright
© 2016 Elsevier Inc. All rights reserved.