Journal of Emergencies, Trauma, and Shock
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ORIGINAL ARTICLE
Year : 2012  |  Volume : 5  |  Issue : 1  |  Page : 28-32

Feasibility and safety of ultrasound-guided nerve block for management of limb injuries by emergency care physicians


1 Department of Emergency Medicine, JPN Apex Trauma Centre, All India Institute of Medical Sciences, New Delhi, India
2 Department of Surgery, JPN Apex Trauma Centre, All India Institute of Medical Sciences, New Delhi, India
3 Department of Emergency Medicine,Lady Harding Medical College, New Delhi, India
4 Department of Emergency Medicine, University of South Florida, Tampa, USA

Correspondence Address:
Sanjeev Bhoi
Department of Emergency Medicine, JPN Apex Trauma Centre, All India Institute of Medical Sciences, New Delhi
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0974-2700.93107

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Background: Patients require procedural sedation and analgesia (PSA) for the treatment of acute traumatic injuries. PSA has complications. Ultrasound (US) guided peripheral nerve block is a safe alternative. Aim: Ultrasound guided nerve blocks for management of traumatic limb emergencies in Emergency Department (ED). Setting and Design: Prospective observational study conducted in ED. Materials and Methods: Patients above five years requiring analgesia for management of limb emergencies were recruited. Emergency Physicians trained in US guided nerve blocks performed the procedure. Statistical analysis: Effectiveness of pain control, using visual analogue scale was assessed at baseline and at 15 and 60 minutes after the procedure. Paired t test was used for comparison. Results: Fifty US guided nerve blocks were sciatic- 4 (8%), femoral-7 (14%), brachial- 29 (58%), median -6 (12%), and radial 2 (4%) nerves. No patients required rescue PSA. Initial median VAS score was 9 (Inter Quartile Range [IQR] 7-10) and at 1 hour was 2(IQR 0-4). Median reduction in VAS score was 7.44 (IQR 8-10(75%), 1-2(25%) (P=0.0001). Median procedure time was 9 minutes (IQR 3, 12 minutes) and median time to reduction of pain was 5 minutes (IQR 1,15 minutes). No immediate or late complications noticed at 3 months. Conclusion: Ultrasound-guided nerve blocks can be safely and effectively performed for upper and lower limb emergencies by emergency physicians with adequate training.


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