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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