Sunday, October 7, 2012

Digital block



Digital nerve blocks are important tools for the emergency medicine clinician. Injuries or infections of the digits are extremely common. Adequate analgesia is essential to properly address the presenting condition and to minimize the patient's discomfort. Digital blocks are useful in many scenarios in which local infiltration of an anesthetic would require several injections into the already painful site of injury. Furthermore, local infiltration around the wound may create increased swelling, making the repair more difficult. Several techniques are available for performing digital blocks.

Indications

Digital blocks are indicated for any minor surgery or procedure of the digits. These include, but are not limited to, the following:

    Large irregular lacerations
    Lacerations involving the nail or the nail bed
    Ingrown nails
    Felon or paronychia
    Trephination of subungual hematoma
    Digit dislocations or fractures

Contraindications

    Compromised digit circulation
    Infected injection site
    Known allergy to anesthetic

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