Hematoma block - Revision history

Elcatracho: /* Pearls */

2021-02-11T22:50:15Z

Pearls

← Older revision		Revision as of 22:50, 11 February 2021
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	*Can use C-arm to guide the needle to the fracture site to increase the chance of successful block in distal radius fractures		*Can use C-arm to guide the needle to the fracture site to increase the chance of successful block in distal radius fractures
	*If it has been several hours since injury, hematoma may have already started to organize and be unaspiratable		*If it has been several hours since injury, hematoma may have already started to organize and be unaspiratable
			*[[Ultrasound]]-guidance may improve success<ref>Gottlieb M, Cosby K. Ultrasound-guided hematoma block for distal radial and ulnar fractures. J Emerg Med. 2015;48(3):310-312. doi:10.1016/j.jemermed.2014.09.063</ref>

	==See Also==		==See Also==

2019-10-09T16:19:34Z

← Older revision		Revision as of 16:19, 9 October 2019
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	*Method of providing local anesthesia/analgesia around the site of a fracture as an alternative to procedural sedation when reduction or manipulation is required		*Method of providing local anesthesia/analgesia around the site of a fracture as an alternative to procedural sedation when reduction or manipulation is required
	*Involves injecting anesthetic into the hematoma that forms around fracture site		*Involves injecting anesthetic into the hematoma that forms around fracture site
	*Commonly used for [[Colles' fracture]] and ankle ~~fractures~~		*Commonly used for [[Colles' fracture]] and [[ankle fracture]]s

	==Indications==		==Indications==

2017-04-14T15:02:41Z

ref

← Older revision		Revision as of 15:02, 14 April 2017
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	**Advance needle until bone encountered		**Advance needle until bone encountered
	**Aspirate until blood is seen to confirm placement within hematoma		**Aspirate until blood is seen to confirm placement within hematoma
	**Inject anesthetic (5 to 15 mL of plain 1% lidocaine or 5 to 10 mL of plain 2% lidocaine)		**Inject anesthetic (5 to 15 mL of plain 1% lidocaine or 5 to 10 mL of plain 2% lidocaine) <ref name="Local and Topical Anesthesia">McGee D. Local and Topical Anesthesia. In: Roberts and Hedges' Clinical Procedures in Emergency Medicine. 6th ed. Philadelphia, PA: Elsevier; 2014. </ref>
	***Goal is to anesthetize bone and periosteum		***Goal is to anesthetize bone and periosteum
	*Remove needle, apply pressure with gauze		*Remove needle, apply pressure with gauze

2017-04-14T15:01:57Z

Procedure: clarification

← Older revision		Revision as of 15:01, 14 April 2017
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	*Position extremity on hard surface		*Position extremity on hard surface
	*Find landmarks		*Find landmarks
	**~~fracture~~ site based on imaging		**Fracture site based on imaging
	**~~area~~ of swelling or deformity		**Area of swelling or deformity
	*Draw up anesthetic		*Draw up anesthetic
	*Prep skin		*Prep skin
	*~~Inject anesthetic~~		*Enter skin directly over fracture
	**enter skin directly over fracture		**Advance needle until bone encountered
	**~~advance towards fracture while aspirating~~		**Aspirate until blood is seen to confirm placement within hematoma
	**~~Once~~ hematoma is ~~aspirator, stop~~ and ~~inject anesthetic~~		**Inject anesthetic (5 to 15 mL of plain 1% lidocaine or 5 to 10 mL of plain 2% lidocaine)
			***Goal is to anesthetize bone and periosteum
	*Remove needle, apply pressure with gauze		*Remove needle, apply pressure with gauze
	*Dress site		*Dress site, proceed with reduction(s) only after 5-10 minutes when block is fully in effect

	==Pearls==		==Pearls==

2017-04-08T03:20:53Z

Background

← Older revision		Revision as of 03:20, 8 April 2017
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	*Method of providing local anesthesia/analgesia around the site of a fracture as an alternative to procedural sedation when reduction or manipulation is required		*Method of providing local anesthesia/analgesia around the site of a fracture as an alternative to procedural sedation when reduction or manipulation is required
	*Involves injecting anesthetic into the hematoma that forms around fracture site		*Involves injecting anesthetic into the hematoma that forms around fracture site
	*Commonly used for [[Colles' fracture]]		*Commonly used for [[Colles' fracture]] and ankle fractures

	==Indications==		==Indications==

2017-04-08T03:20:35Z

Pearls

← Older revision		Revision as of 03:20, 8 April 2017
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	==Pearls==		==Pearls==
	*Can use a combination of lidocaine and bupivicaine for rapid onset and longer acting analgesia/anesthesia		*Can use a combination of lidocaine and bupivicaine for rapid onset and longer acting analgesia/anesthesia
	*Can use C arm to guide the needle to increase the chance of successful block in distal radius fractures		*Can use C-arm to guide the needle to the fracture site to increase the chance of successful block in distal radius fractures
	*If it has been several hours since injury, hematoma may have already started to organize and be unaspiratable		*If it has been several hours since injury, hematoma may have already started to organize and be unaspiratable

2017-04-08T03:20:10Z

Pearls

← Older revision		Revision as of 03:20, 8 April 2017
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	==Pearls==		==Pearls==
	*Can use a combination of lidocaine and bupivicaine for rapid onset and longer acting analgesia/anesthesia		*Can use a combination of lidocaine and bupivicaine for rapid onset and longer acting analgesia/anesthesia
			*Can use C arm to guide the needle to increase the chance of successful block in distal radius fractures
	*If it has been several hours since injury, hematoma may have already started to organize and be unaspiratable		*If it has been several hours since injury, hematoma may have already started to organize and be unaspiratable

2016-10-05T04:08:39Z

2016-09-10T23:12:48Z

← Older revision		Revision as of 23:12, 10 September 2016
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	*Method of providing local anesthesia/analgesia around the site of a fracture as an alternative to procedural sedation when reduction or manipulation is required		*Method of providing local anesthesia/analgesia around the site of a fracture as an alternative to procedural sedation when reduction or manipulation is required
	*Involves injecting anesthetic into the hematoma that forms around fracture site		*Involves injecting anesthetic into the hematoma that forms around fracture site
	*Commonly used for Colles' fracture		*Commonly used for [[Colles' fracture]]

	==Indications==		==Indications==
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	==References==		==References==
	<references/>		<references/>

			[[Category:Procedures]] [[Category:Orthopedics]]

2016-09-07T04:39:22Z

External Links

← Older revision		Revision as of 04:39, 7 September 2016
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	==External Links==		==External Links==
	*[[https://www.youtube.com/watch?v=EhJ7kpurKnk]]		*https://www.youtube.com/watch?v=EhJ7kpurKnk
	*[[http://epmonthly.com/article/hematoma-blocks-for-reduction-of-distal-radius-fractures/]]		*http://epmonthly.com/article/hematoma-blocks-for-reduction-of-distal-radius-fractures/

	==References==		==References==
	<references/>		<references/>