Photo Credit: Pikovit44

The following is a summary of “Safety and Pain Reduction in Emergency Practitioner Ultrasound-Guided Nerve Blocks: A One-Year Retrospective Study,” published in the January 2024 issue of Emergency Medicine by Merz-Herrala, et al.

Emergency room doctors use ultrasound-guided nerve blocks to ease pain. This study has the most records of single-injection ultrasound-guided nerve blocks done in an emergency department (ED). For a study, researchers sought to find out if ultrasound-guided nerve blocks done by an ED were safe and helped lower pain scores. They were most interested in the rates of complications with ultrasound-guided nerve blocks and the changes in how much pain patients reported (0 to 10 on the VAS) before and after the blocks. 

Types of ultrasound-guided nerve blocks and their uses during the study time were also interesting. Through chart review over a year in the Highland ED, the study looks back at 420 ultrasound-guided nerve blocks that emergency doctors did. During the study, four emergency physicians reviewed all the templated notes and nurse records for ultrasound-guided nerve blocks. Ten randomly chosen charts were used to test inter-rater dependability. All 70 key factors were agreed upon by all 10 raters (Kappa=1, P<.001). 75 different emergency room doctors did 420 ultrasound-guided nerve blocks. Ultrasound-guided nerve blocks were mostly done by emergency room residents (61.9%), advanced practice practitioners (21.2%), faculty with an ultrasound fellowship (8.3%), interns (3.6%), faculty without an ultrasound fellowship (3.3%), and people who didn’t record their procedure (1.7%). During the study, there was one problem: an artery puncture was found through needle suction, but there were no other effects. Out of the 261 ultrasound-guided nerve blocks that had pain scores before and after the block, the pain scores after the block got better. The mean pain scores went down from 7.4 to 2.8 after a nerve block guided by ultrasound (difference 4.6, 95% CI 3.9 to 5.2). 

The one-year study showed that ultrasound-guided nerve blocks done by an emergency doctor have a low rate of complications and are linked to less pain.

Source: sciencedirect.com/science/article/abs/pii/S0196064423011393