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Just the facts: brachial plexus blocks for upper extremity injuries in the emergency department.
Mirsch, Daniel; Jelic, Tomislav; Prats, Michael I; Dreyfuss, Andrea; Yates, Evan; Kummer, Tobias; Stenberg, Bob; Vlasica, Katherine; Nagdev, Arun.
Afiliación
  • Mirsch D; University at Buffalo, SUNY, Amherst, NY, USA.
  • Jelic T; Department of Emergency Medicine, Health Sciences Centre/St.Boniface Hospital, University of Manitoba, Winnipeg, MB, Canada. tjelic@gmail.com.
  • Prats MI; The Ohio State University Wexner Medical Center, Columbus, OH, USA.
  • Dreyfuss A; Department at Hennepin Healthcare, University of Minnesota School of Medicine, Minneapolis, MN, USA.
  • Yates E; School of Medicine, Ronald O. Perelman Department of Emergency Medicine at NYU Grossman, NYU Langone Health, New York, NY, USA.
  • Kummer T; Mayo Clinic, Rochester, MN, USA.
  • Stenberg B; Northeast Ohio Medical School, Cleveland Clinic Akron General, Rootstown, OH, USA.
  • Vlasica K; RowanSOM St Joseph's Health, Paterson, NJ, USA.
  • Nagdev A; Highland Hospital/Alameda Health System, University of California, San Francisco, CA, USA.
CJEM ; 26(4): 228-231, 2024 Apr.
Article en En | MEDLINE | ID: mdl-38060159
Ultrasound-guided nerve blocks (UGNBs) are becoming a more common method for pain control in the emergency department. Specifically, brachial plexus blocks have shown promise for acute upper extremity injuries as well as an alternative to procedural sedation for glenohumeral reductions. Unfortunately, there is minimal discussion in the EM literature regarding phrenic nerve paralysis (a well-known complication from brachial plexus blocks). The anatomy of the brachial plexus, its relationship to the phrenic nerve, and why ultrasound-guided brachial plexus blocks can cause phrenic nerve paralysis and resultant respiratory impairment will be discussed. The focus on patient safety is paramount, and those with preexisting respiratory conditions, extremes of age or weight, spinal deformities, previous neck injuries, and anatomical variations are at greater risk. We put forth different block strategies for risk mitigation, including patient selection, volume and type of anesthetic, block location, postprocedural monitoring, and specific discharge instructions. Understanding the benefits and risks of UGNBs is critical for emergency physicians to provide effective pain control while ensuring optimal patient safety.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Bloqueo del Plexo Braquial Límite: Humans Idioma: En Revista: CJEM Asunto de la revista: MEDICINA DE EMERGENCIA Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Reino Unido
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Bloqueo del Plexo Braquial Límite: Humans Idioma: En Revista: CJEM Asunto de la revista: MEDICINA DE EMERGENCIA Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Reino Unido