Contributor: Jared Scott, MD Educational Pearls: About ½ of the patients in the ED present with some form of pain One study looked at patients presenting in pain and followed up two days after discharge to determine if their pain was addressed, asking if the patient received anything for pain and if the patient refused…
Read MoreContributor: Don Stader, MD Educational Pearls: Fractures and dislocations that require reduction do not necessarily require sedation Nerve blocks are an effective alternative that can provide analgesia to reduce fractures and dislocations and provide sustained pain relief after the reduction is completed Hematoma blocks are effective for distal radius and various ankle fractures Shoulder dislocations…
Read MoreContributor: Don Stader, MD Educational Pearls: Local anesthetics injected directly into wounds can cause distortion – especially important in facial lacerations Several blocks can be helpful to help numb branches of the trigeminal nerve (CN V) which innervates the face: Supraorbital nerve block: blocks distribution of V1 (most of the forehead) through injection above the…
Read MoreContributor: Jared Scott, MD Educational Pearls: Traditional digital block involves dorsal approach on either side of the digit, injecting local anesthetic along each side to numb all four nerves of the digit Newer approach involves a single injection along the palmar surface at MCP joint Recent study further compared a proximal vs distal single palmar…
Read MoreAuthor: Don Stader, MD Educational Pearls: Suboxone, methadone, and naltrexone are commonly used as treatments for opiate use disorder. Naltrexone is a full mu-opiate receptor antagonist, making acute pain control difficult in patients taking it. Options for pain control in patients on naltrexone include nerve blocks, NSAIDS, ketamine, and high doses of opiates. Of the…
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