Nerve Block: Ulnar Nerve: Difference between revisions
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==Procedure== | ==Procedure== | ||
[[File:Blind_Ulnar_Nerve_Block.jpg|thumb|Ulnar Nerve Block at the Wrist]] | |||
* Place the patient's extremity in the supinated position | * Place the patient's extremity in the supinated position | ||
* Cleanse the skin with chosen antiseptic | * Cleanse the skin with chosen antiseptic | ||
* Create a sterile field using your sterile drape | * Create a sterile field using your sterile drape | ||
===Non-Ultrasound Guided Technique=== | ===Non-Ultrasound Guided Technique=== | ||
* In a sterile fashion, apply a small wheel of local anesthetic to the area immediately ulnar to tendon of the Flexor Carpi Ulnaris approximately 2 cm proximal to the wrist crease. | * In a sterile fashion, apply a small wheel of local anesthetic to the area immediately ulnar to tendon of the Flexor Carpi Ulnaris approximately 2 cm proximal to the wrist crease. | ||
* The ulnar nerve should be immediately deep to the Flexor Carpi Ulnaris Tendon | |||
* Direct the Needle radially, deep to the Flexor Carpi Ulnaris | |||
* The ulnar nerve is ulnar in relation to the ulnar artery; even still, it is important to aspirate prior to injecting anesthetic to rule out intra-arterial placement | |||
* Inject approximately 5 mL of local anesthetic | |||
===Ultrasound Guided Technique=== | ===Ultrasound Guided Technique=== | ||
==References== | ==References== | ||
<references/> | <references/> | ||
Revision as of 04:51, 28 January 2017
Background
- This has been found to be a quick, safe, and effective means of pain reduction for hand injuries, including reduction of Boxer's Fractures. [1]
Indications
Contraindications
- Overlying site infection
- Injury requiring close neurologic observation (e.g. Compartment Syndrome)
Equipment Needed
- 10 cc Syringe with a 27 Gauge Needle
- Spare 18 Gauge Needle (to draw up anesthetic)
- Local Anesthetic (e.g. Lidocaine vs Bupivacaine)
- Antiseptic (e.g. Chlorhexidine, Betadine, Rubbing Alcohol)
- Sterile Gloves
- Sterile Drape
- Linear Ultrasound Probe (for ultrasound guided procedure)
- Sterile Ultrasound Prove Cover (for ultrasound guided procedure)
Procedure
- Place the patient's extremity in the supinated position
- Cleanse the skin with chosen antiseptic
- Create a sterile field using your sterile drape
Non-Ultrasound Guided Technique
- In a sterile fashion, apply a small wheel of local anesthetic to the area immediately ulnar to tendon of the Flexor Carpi Ulnaris approximately 2 cm proximal to the wrist crease.
- The ulnar nerve should be immediately deep to the Flexor Carpi Ulnaris Tendon
- Direct the Needle radially, deep to the Flexor Carpi Ulnaris
- The ulnar nerve is ulnar in relation to the ulnar artery; even still, it is important to aspirate prior to injecting anesthetic to rule out intra-arterial placement
- Inject approximately 5 mL of local anesthetic
Ultrasound Guided Technique
References
- ↑ Ünlüer, EE. Ultrasound-guided Ulnar Nerve Block For Boxers Fractures. Am. J. Emerg. Med. 2016; 34 (8): 1726.