Hematoma block: Difference between revisions
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==Background== | ==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== | ==Indications== | ||
* | *Need for closed reduction or manipulation of any diaphyseal or metaphyseal fracture | ||
==Contraindications== | ==Contraindications== | ||
* | *Open fracture | ||
==Equipment== | ==Equipment== | ||
*Sterile gloves | *Sterile gloves | ||
*Sterile | *Sterile gauze | ||
*Antiseptic (e.g. chlorhexidine or alcohol) | *Antiseptic (e.g. chlorhexidine or alcohol) | ||
* | *Syringe | ||
*Needles (large bore for drawing up local, small gauge for injection) | *Needles (large bore for drawing up local, small gauge for injection) | ||
*Anesthetic (e.g. 2% [[lidocaine]] | *Anesthetic (e.g. 2% [[lidocaine]] or 0.5% bupivicaine) | ||
==Procedure== | ==Procedure== | ||
| Line 27: | Line 27: | ||
*Inject anesthetic | *Inject anesthetic | ||
**enter skin directly over fracture | **enter skin directly over fracture | ||
** | **advance towards fracture while aspirating | ||
** | **Once hematoma is aspirator, stop and inject anesthetic | ||
*Remove needle, apply pressure with gauze | *Remove needle, apply pressure with gauze | ||
*Dress site | *Dress site | ||
==Pearls== | ==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 | *If it has been several hours since injury, hematoma may have already started to organize and be unaspiratable | ||
==See Also== | ==See Also== | ||
[[Colles' Fracture]] | *[[Colles' Fracture]] | ||
[[Procedural Sedation]] | *[[Procedural Sedation]] | ||
==External Links== | ==External Links== | ||
*[[https://www.youtube.com/watch?v=EhJ7kpurKnk]] | |||
https://www.youtube.com/watch?v=EhJ7kpurKnk | *[[http://epmonthly.com/article/hematoma-blocks-for-reduction-of-distal-radius-fractures/]] | ||
http://epmonthly.com/article/hematoma-blocks-for-reduction-of-distal-radius-fractures/ | |||
==References== | ==References== | ||
</references> | |||
Revision as of 01:18, 2 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
References
</references>