I wanted to get input from anyone who's had experience using Bier blocks for fracture reductions. I've had several cases in the past couple of weeks where kids sustained a distal upper extremity fracture (which require reduction) and ate something shortly prior to ED arrival. Moderate sedation isnt an option and getting into the OR within a reasonable time frame isn't possible.
1. Is the Bier block practical for use in the ED? When used, how long after do you monitor the patient for?
2. Would you prefer it in fracture reductions versus if moderate sedation was an option?
3. Other than the potential of lidocaine causing an arrhythmia if improperly done, what complications have you seen from the Bier block?
Any input is appreciated.
Musab Al-Yahia, MD
Gulf Coast Medical Center Emergency Room
Panama City, Florida
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