The Almighty Hematoma Block for Wrist Fractures

This study found a "statistically significant difference during initial hours after fracture reduction and fixation so that pain intensity was less in elderly patients under hematoma block than patients who underwent general anesthesia in one and six hours after surgery." Most importantly, patients in the hematoma block group required less narcotic pain medication compared with the general surgery population.Experienced providers often know exactly where to inject anesthesia for hematoma blocks. Ultrasound-guided injection techniques, however, prove to be more accurate. Using ultrasound to identify the hematoma and fracture before and during injection will improve technique when landmark localization is difficult. (J Emerg Med 2015;48[3]:310.).​Hematoma blocks also work very well for wrist fractures in children. Not only do hematoma blocks provide adequate pain control, they also increase patient satisfaction and decrease length of stay and need for resources in the emergency department compared with the use of moderate or deep sedation. (J Hand Surg Am 2015;40[1]:57.)Wrist fracture reduced and splinted after using a hematoma block. Photo by Martha Roberts.The ProcedureHematoma block of the wrist for wrist fracture using a lidocaine injection.The ApproachReview radiographs and locate the wrist fracture. Mark the area you plan to inject with a pen.Have the patient supine on the stretcher. Dissuade the patient from watching you complete the setup and injecti...
Source: The Procedural Pause - Category: Emergency Medicine Tags: Blog Posts Source Type: blogs