Hematoma block: Difference between revisions
ClaireLewis (talk | contribs) No edit summary |
|||
| Line 2: | Line 2: | ||
*Method of providing local anesthesia/analgesia around the site of a fracture as an alternative to procedural sedation when reduction or manipulation is required | *Method of providing local anesthesia/analgesia around the site of a fracture as an alternative to procedural sedation when reduction or manipulation is required | ||
*Involves injecting anesthetic into the hematoma that forms around fracture site | *Involves injecting anesthetic into the hematoma that forms around fracture site | ||
*Commonly used for Colles' fracture | *Commonly used for [[Colles' fracture]] | ||
==Indications== | ==Indications== | ||
| Line 46: | Line 46: | ||
==References== | ==References== | ||
<references/> | <references/> | ||
[[Category:Procedures]] [[Category:Orthopedics]] | |||
Revision as of 23:12, 10 September 2016
Background
- Method of providing local anesthesia/analgesia around the site of a fracture as an alternative to procedural sedation when reduction or manipulation is required
- Involves injecting anesthetic into the hematoma that forms around fracture site
- Commonly used for Colles' fracture
Indications
- Need for closed reduction or manipulation of any diaphyseal or metaphyseal fracture
Contraindications
- Open fracture
Equipment
- Sterile gloves
- Sterile gauze
- Antiseptic (e.g. chlorhexidine or alcohol)
- Syringe
- Needles (large bore for drawing up local, small gauge for injection)
- Anesthetic (e.g. 2% lidocaine or 0.5% bupivicaine)
Procedure
- Position extremity on hard surface
- Find landmarks
- fracture site based on imaging
- area of swelling or deformity
- Draw up anesthetic
- Prep skin
- Inject anesthetic
- enter skin directly over fracture
- advance towards fracture while aspirating
- Once hematoma is aspirator, stop and inject anesthetic
- Remove needle, apply pressure with gauze
- Dress site
Pearls
- Can use a combination of lidocaine and bupivicaine for rapid onset and longer acting analgesia/anesthesia
- If it has been several hours since injury, hematoma may have already started to organize and be unaspiratable
See Also
External Links
- https://www.youtube.com/watch?v=EhJ7kpurKnk
- http://epmonthly.com/article/hematoma-blocks-for-reduction-of-distal-radius-fractures/