Bringing Ultrasound‐guided Regional Anesthesia to Emergency Medicine

Herring, Andrew A.

doi:10.1002/aet2.10027

Cited by 15 publications

(14 citation statements)

References 15 publications

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“…It could be shown that emergency physicians, after a minimum requirement of 2 days of instruction, were able to perform UGR in dozens of patients with distal radius fractures. This is a novel finding, as only a few attempts to bring regional anaesthesia to emergency medicine have been noted [11].…”

Section: Discussionmentioning

confidence: 93%

“…In the operative setting, brachial plexus block has shown benefits for pain management, muscle relaxation and hospital discharge [8]. Several studies have shown that all the advantages of the brachial plexus block can be extended to the emergency department [9][10][11]. Ultrasound-guided regional anaesthesia (UGRA) is a reliable method to achieve an efficient and effective brachial plexus block with fewer side effects than when the procedure is performed without sonographic visualisation [11,12].…”

Section: Introductionmentioning

confidence: 99%

“…Several studies have shown that all the advantages of the brachial plexus block can be extended to the emergency department [9][10][11]. Ultrasound-guided regional anaesthesia (UGRA) is a reliable method to achieve an efficient and effective brachial plexus block with fewer side effects than when the procedure is performed without sonographic visualisation [11,12]. So far, most studies have used radiological endpoints to measure the quality of distal radius fractures treatment [4,13].…”

Section: Introductionmentioning

confidence: 99%

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Ultrasound-guided regional anaesthesia and reduction of distal radius fractures in an emergency department

Ammann¹,

Schoell²,

Ortega³

et al. 2020

Swiss Med Wkly

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OBJECTIVES: Distal radius fractures are among the most common fractures. Ultrasound is gaining importance in the treatment of and as a tool to diagnose distal radius fractures, guide regional anaesthesia and support reductions. Our aim was to demonstrate safety, feasibility and outcome in patients with a distal radius fractures undergoing ultrasound-guided regional anaesthesia (UGRA) with ultrasound-guided reduction (UGR), as compared with procedural sedation for the reduction.METHODS: This retrospective cohort study was carried out in the emergency department of the University Hospital Basel (Switzerland) between February 2014 and October 2017. Adults with an isolated forearm fracture were eligible. The intervention group was treated with UGRA of the brachial plexus and subsequent ultrasound-assisted fracture reduction. Patients in the control group received usual care, which is blind fracture reduction with extension and immobilisation under procedural sedation. RESULTS: 71 patients were enrolled in the intervention group and 142 were to the control group. There was one (1.4%) complication (pneumothorax) in the UGR group. Twenty-five patients (35%) in the intervention group and 67 patients (47%) in the control group underwent surgery. The association between surgery and study group was not significant (p = 0.08). The patient's age was negatively associated with surgery (p <0.001). The association between surgery and study group was significant in patients ≥60 years (p = 0.035). CONCLUSION:The combination of ultrasound-guided regional anaesthesia and ultrasound-guided reduction of distal radius fractures is feasible. Safety was shown by 70 out of 71 cases of UGRA being without complication. Effectiveness regarding the necessity of subsequent operation was comparable to usual care; in patients over 60 it may be lower with UGR.

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Section: Discussionmentioning

confidence: 93%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Ultrasound-guided regional anaesthesia and reduction of distal radius fractures in an emergency department

Ammann¹,

Schoell²,

Ortega³

et al. 2020

Swiss Med Wkly

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“…A literature review was performed with the assistance of a librarian and a list of specific UGRA concepts and techniques was assembled. This included items from published peer‐reviewed manuscripts and textbooks in EM and anesthesia literature 12–26 . Online resources and resources that were not subject to peer review were not reviewed for possible curriculum elements.…”

Section: Methodsmentioning

confidence: 99%

“…This included items from published peer-reviewed manuscripts and textbooks in EM and anesthesia literature. [12][13][14][15][16][17][18][19][20][21][22][23][24][25][26] Online resources and resources that were not subject to peer review were not reviewed for possible curriculum elements. A multi-institutional expert panel of 13 EM physicians with advanced ultrasound training was assembled via a convenience sample.…”

Section: Methodsmentioning

confidence: 99%

Defining an Ultrasound‐guided Regional Anesthesia Curriculum for Emergency Medicine

Tucker

Peterson

Mink

et al. 2020

AEM Education and Training

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Objectives: Ultrasound-guided regional anesthesia (UGRA) can be a powerful tool in the treatment of painful conditions commonly encountered in emergency medicine (EM) practice. UGRA can benefit patients while avoiding the risks of procedural sedation and opioid-based systemic analgesia. Despite these advantages, many EM trainees do not receive focused education in UGRA and there is no published curriculum specifically for EM physicians. The objective of this study was to identify the components of a UGRA curriculum for EM physicians.Methods: A list of potential curriculum elements was developed through an extensive literature review. An expert panel was convened that included 13 ultrasound faculty members from 12 institutions and from a variety of practice environments and diverse geographical regions. The panel voted on curriculum elements through two rounds of a modified Delphi process. Results:The panelists voted on 178 total elements, 110 background knowledge elements, and 68 individual UGRA techniques. A high level of agreement was achieved for 65 background knowledge elements from the categories: benefits to providers and patients, indications, contraindications, risks, ultrasound skills, procedural skills, sterile technique, local anesthetics, and educational resources. Ten UGRA techniques achieved consensus: interscalene brachial plexus, supraclavicular brachial plexus, radial nerve, median nerve, ulnar nerve, serratus anterior plane, fascia iliaca, femoral nerve, popliteal sciatic nerve, and posterior tibial nerve blocks. Conclusions:The defined curriculum represents ultrasound expert opinion on a curriculum for training practicing EM physicians. This curriculum can be used to guide the development and implementation of more robust UGRA education for both residents and independent providers.

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Ultrasound-Guided Peripheral Nerve Blocks: A Practical Review for Acute Cancer-Related Pain

Hao

Fiore

Capua

et al. 2022

Curr Pain Headache Rep

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Bringing Ultrasound‐guided Regional Anesthesia to Emergency Medicine

Cited by 15 publications

References 15 publications

Ultrasound-guided regional anaesthesia and reduction of distal radius fractures in an emergency department

Ultrasound-guided regional anaesthesia and reduction of distal radius fractures in an emergency department

Defining an Ultrasound‐guided Regional Anesthesia Curriculum for Emergency Medicine

Ultrasound-Guided Peripheral Nerve Blocks: A Practical Review for Acute Cancer-Related Pain

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