Who to block and who not to block? Guidelines for Emergency Regional Anesthesiafor Trauma Orthopedic Injuries Block OK • Shoulder dislocation • Clavicle fracture • Proximal humerus fracture • Low energy distal radius fracture • Hand and digit injuries • Hip fracture and dislocation • Low foot and ankle fractures Contact orthopedic surgery as soon as possible for any patients to be admitted or patients who will require in ED consultation, but do not delay block placement Block after Consultation • Humeral shatt fracture • Elbow fracture • Both bone forearm fracture • Femoral shaft fracture Perform and document detailed neurologic examand consult with orthopedic service before block is placed. NO Block - High risk for compartment syndrome • Tibial fracture • High emergency forearm fracture • High Energy foot fracture • Any injury with evidence of neurovascular injury or clinical concem tor a possible compartment syndrorne Perform a block only after requested by Trauma and Orthopedic service attending. Dr. Cian Mcdermott @cianmcdermott #NerveBlock #Indications #Contraindications #Orthopedics #Management #Regional #Anesthesia #Trauma
