scholarly journals Ultrasound-guided regional anesthesia for the pain management of elderly patients with hip fractures in the emergency department

2014 ◽  
Vol 1 (1) ◽  
pp. 49-55 ◽  
Author(s):  
Hee Kyung Lee ◽  
Bo Seung Kang ◽  
Chang Sun Kim ◽  
Hyuk Joong Choi
Keyword(s):  
Emergency Department ◽  
Pain Management ◽  
Elderly Patients ◽  
Regional Anesthesia ◽  
Hip Fractures ◽  
Ultrasound Guided

scholarly journals Identification of teaching priorities for ultrasound-guided regional anesthesia as first-line pain management in a swiss university emergency department

2016 ◽  
Vol 4 (1) ◽  
pp. 2 ◽  
Author(s):  
Eckehart Schöll ◽  
Dieter Kolleth ◽  
Gilbert Krähenbühl ◽  
Christian H Nickel ◽  
Roland Bingisser
Keyword(s):  
Emergency Department ◽  
Pain Management ◽  
Regional Anesthesia ◽  
Ultrasound Guided ◽  
First Line

Acute Care: Pain Management

2019 ◽  
Author(s):  
Claudia Ranniger
Keyword(s):  
Emergency Department ◽  
Pain Management ◽  
Regional Anesthesia ◽  
Acute Pain ◽  
Management Practices ◽  
Rating Scale ◽  
Hand Position ◽  
Ultrasound Guided ◽  
The Face ◽  
Ed Visits

Pain is a chief complaint in more than 50% of emergency department (ED) visits. Injury accounts for approximately one-third of presentations associated with pain; other common diagnoses include neck and back pain, minor infections, abdominal pain, and headache. In the ED, pain is underdiagnosed and undertreated, and existing pain management practices in the ED are inconsistent.  Inadequate pain management is common, and pain remains unchanged or worsens during the ED visit for more than 40% of patients.  Patient satisfaction improves when expectations for pain control are met. This review covers the pathophysiology of pain and the practice of pain management. Figures show the approach to pain management in the ED, an example of a numerical and visual analog scale pain rating scale, field block of the pinna, ultrasound probe and hand position for ultrasound-guided regional anesthesia, regional anesthesia of the face, innervation of the hand and fingers, regional anesthesia of the median, radial and ulnar nerves, innervation of the foot, ultrasound-guided regional anesthesia of the posterior tibialis nerve, regional anesthesia of the sural nerve, and method of regional anesthesia of the dorsal foot.  This review contains 13 figures, 15 tables, and 71 references. Key words: Acute pain, Pain management, Oligoanalgesia, Pain assessment, Inadequate pain management, Acute pain management, Pain management in the emergency department, Pain in the ED, Pain presentation

Acute Care: Pain Management

2020 ◽  
Author(s):  
Claudia Ranniger
Keyword(s):  
Emergency Department ◽  
Pain Management ◽  
Regional Anesthesia ◽  
Acute Pain ◽  
Management Practices ◽  
Rating Scale ◽  
Hand Position ◽  
Ultrasound Guided ◽  
The Face ◽  
Ed Visits

Pain is a chief complaint in more than 50% of emergency department (ED) visits. Injury accounts for approximately one-third of presentations associated with pain; other common diagnoses include neck and back pain, minor infections, abdominal pain, and headache. In the ED, pain is underdiagnosed and undertreated, and existing pain management practices in the ED are inconsistent.  Inadequate pain management is common, and pain remains unchanged or worsens during the ED visit for more than 40% of patients.  Patient satisfaction improves when expectations for pain control are met. This review covers the pathophysiology of pain and the practice of pain management. Figures show the approach to pain management in the ED, an example of a numerical and visual analog scale pain rating scale, field block of the pinna, ultrasound probe and hand position for ultrasound-guided regional anesthesia, regional anesthesia of the face, innervation of the hand and fingers, regional anesthesia of the median, radial and ulnar nerves, innervation of the foot, ultrasound-guided regional anesthesia of the posterior tibialis nerve, regional anesthesia of the sural nerve, and method of regional anesthesia of the dorsal foot.  This review contains 13 figures, 16 tables, and 72 references. Key words: Acute pain, Pain management, Oligoanalgesia, Pain assessment, Inadequate pain management, Acute pain management, Pain management in the emergency department, Pain in the ED, Pain presentation

Ultrasound-Guided Regional Anesthesia of the Femoral Nerve in the Pediatric Emergency Department

2022 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Michael A. Heffler ◽  
Julia A. Brant ◽  
Amar Singh ◽  
Amanda G. Toney ◽  
Maya Harel-Sterling ◽  
...  
Keyword(s):  
Emergency Department ◽  
Regional Anesthesia ◽  
Femoral Nerve ◽  
Pediatric Emergency ◽  
Pediatric Emergency Department ◽  
Ultrasound Guided

scholarly journals MP024: Ultrasound-guided femoral nerve block versus fascia iliaca block for hip fractures in the emergency department: a randomized pilot study

CJEM ◽  
2016 ◽  
Vol 18 (S1) ◽  
pp. S74-S74
Author(s):  
J. Chenkin ◽  
J.S. Lee ◽  
T. Bhandari ◽  
R. Simard
Keyword(s):  
Emergency Department ◽  
Pilot Study ◽  
Nerve Block ◽  
Hip Fractures ◽  
Femoral Nerve Block ◽  
Femoral Nerve ◽  
Comfort Level ◽  
Ultrasound Guided ◽  
Nerve Blocks ◽  
Pain Scores

Introduction: Regional anesthesia has been shown to be an effective pain control strategy for patients presenting with hip fractures in the emergency department. There are two common methods for performing this block: the femoral nerve block (FNB) and the fascia iliaca compartment block (FICB). The objective of this pilot study is to determine whether one of these two ultrasound-guided block techniques provides superior analgesia to emergency department patients with hip fractures. Methods: Emergency physicians at a single institution were randomized to the FNB or FICB training groups. Participants completed a 2-hour practical workshop covering the technique, followed by a questionnaire to assess their comfort with the block. They were asked to perform their assigned nerve block on any patient in the ED presenting with a hip or femur fracture. Physician comfort level and patient pain scores using a visual analog scale (VAS) were recorded before and after the nerve block were recorded. Comparisons were performed using Student’s t-test and Fisher’s exact test. Results: A total of 20 physicians were enrolled in the study, 10 in the FNB group and 10 in the FICB group. There were no significant baseline differences between the groups with respect to ultrasound or nerve block experience. Following the training, 100% of participants in both the FNB group and FICB group felt comfortable performing the block. Nerve blocks were performed in 30/51 (58.8%) of eligible patients in the FNB group and 6/11 (54.5%) in the FICB group (p=1.0). On the 10-point VAS, pain scores decreased by a mean of 4.9 (SD 3.5) in the FNB group and 8.3 (SD 2.4) in the FICB group (p=0.056). In practice, physicians felt comfortable performing the FNB in 52.8% of cases, and the FICB in 85.7% of cases (p=0.21). Mean time to completion of the blocks was similar between the two groups (19 vs 18 mins, p=0.83). Conclusion: In this pilot study, we found a non-significant trend towards improved analgesia and higher physician comfort with the ultrasound-guided FICB compared with the FNB in patients with hip fractures. We found no differences in time to performing the blocks. These results require confirmation with a larger sample size.

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