Hi folks.
On todays episode I discuss prehospital ultrasound guided nerve blocks in a RCT compared with IV sedation-analgesia for management of limb injury pain and reduction of joint dislocations.
show notes:
Podcast ( available here and on iTunes)
Right Click and Choose Save-as to Download the Podcast.
ketaminh
ntrueger
Yen Chow
At 7 mins you talked about diagnosis of compartment syndrome and not just reliant on pain for diagnosis. The problem with that is pain is the diagnosis. I agree the risk is low, and that nerve blocks are definitely the way forward, but your minimisation and description of how you would look at compartment syndrome shows a lack of understanding of the problem. Firmness of compartments is not really considered, and USS of differing compartments is not readily available on the wards where the problem will present. Other than that great podcast and I am a fan of nerve blocks and the use pre-hospital makes a lot of sense.
thanks Paul. Pain is a major symptom of compartment syndrome but you just cant rely upon it solely. We deal with unconscious or non verbal patients and so you need other methods to assess for it. If you do blocks then it helps I think for doing pressure readings on the compartment, Then at least you are doing objective measurements of the pressure.
also in my experience and borne out in the literature, pain of acute compartment syndrome will breakthrough a nerve block or any other analgesia