Ultrasound-guided interscalene block for shoulder dislocation reduction in the ED

The American Journal of Emergency Medicine
Michael Blaivas, Matthew Lyon

Abstract

Shoulder dislocations are often associated with significant pain, and many emergency physicians choose conscious sedation to achieve reduction. Concerns about oxygenation, airway protection, and aspiration may make some patients poor candidates for conscious sedation. Ideally, complete pain control and muscle relaxation could be achieved without airway compromise. Interscalene nerve blocks are routinely used for shoulder surgery in the operating suite. The equipment required to locate the nerve plexus blindly is typically not available in the ED setting. Recent work has shown that ultrasound guidance is ideal for the interscalene block and would make it possible in the ED. We present 4 cases of patients receiving ultrasound-guided interscalene blocks for pain control and muscle relaxation during shoulder reduction. Complete pain control, muscle relaxation, and joint reduction were achieved in each case.

References

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Citations

Feb 19, 2010·Journal of Emergencies, Trauma, and Shock·Sanjeev BhoiSagar Galwankar
Nov 22, 2015·The American Journal of Emergency Medicine·Turandot SaulNicholas C Avitabile
May 15, 2012·Annals of Emergency Medicine·Suzanne C LippertRobert Norris
Nov 27, 2010·The American Journal of Emergency Medicine·Andrew A HerringArun Nagdev
Mar 13, 2010·The American Journal of Emergency Medicine·Michael B StoneMichael Blaivas
Mar 27, 2009·Annals of Emergency Medicine·Uché Blackstock, Michael B Stone
Jun 7, 2008·The American Journal of Emergency Medicine·Stephen M Howell, Mario E Serafini
May 15, 2008·Acta Anaesthesiologica Scandinavica·Z J Koscielniak-Nielsen
Sep 3, 2011·Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine·Michael BlaivasLina Lander
Feb 24, 2015·The American Journal of Emergency Medicine·Graham Brant-Zawadzki, Andrew Herring
Mar 16, 2013·The Journal of Emergency Medicine·David C Mackenzie, Otto Liebmann
May 22, 2016·Anesthesiology Clinics·Sergey M Motov, Lewis S Nelson
Nov 12, 2009·Expert Review of Neurotherapeutics·Andreas Grabinsky, Sam R Sharar
Jan 10, 2012·International Anesthesiology Clinics·Ramprasad Sripada, Clifford Bowens
Jun 8, 2012·Current Opinion in Anaesthesiology·Frederik De BuckMarc Van de Velde
May 25, 2021·Anesthesiology Clinics·Robert Vietor, Chester Buckenmaier
Jul 31, 2012·Annales Françaises D'anesthèsie Et De Rèanimation·E Gaertner, H Bouaziz

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