Ultrasound-guided nerve blocks in emergency medicine practice: 2022 updates. Goldsmith, A. J., Brown, J., Duggan, N. M., Finkelberg, T., Jowkar, N., Stegeman, J., Riscinti, M., Nagdev, A., & Amini, R. The American Journal of Emergency Medicine, 78:112–119, April, 2024. doi abstract bibtex OBJECTIVES: In the Emergency Department (ED), ultrasound-guided nerve blocks (UGNBs) have become a cornerstone of multimodal pain regimens. We investigated current national practices of UGNBs across academic medical center EDs, and how these trends have changed over time. METHODS: We conducted a cross-sectional electronic survey of academic EDs with ultrasound fellowships across the United States. Twenty-item questionnaires exploring UGNB practice patterns, training, and complications were distributed between November 2021-June 2022. Data was manually curated, and descriptive statistics were performed. The survey results were then compared to results from Amini et al. 2016 UGNB survey to identify trends. RESULTS: The response rate was 80.5% (87 of 108 programs). One hundred percent of responding programs perform UGNB at their institutions, with 29% (95% confidence interval (CI), 20%-39%) performing at least 5 blocks monthly. Forearm UGNB are most commonly performed (96% of programs (95% CI, 93%-100%)). Pain control for fractures is the most common indication (84%; 95% CI, 76%-91%). Eighty-five percent (95% CI, 77%-92%) of programs report at least 80% of UGNB performed are effective. Eighty-five percent (95% CI, 66%-85%) of programs have had no reported complications from UGNB performed by emergency providers at their institution. The remaining 15% (95% CI, 8%-23%) report an average of 1 complication annually. CONCLUSIONS: All programs participating in our study report performing UGNB in their ED, which is a 16% increase over the last 5 years. UGNB's are currently performed safely and effectively in the ED, however practice improvements can still be made. Creating multi-disciplinary committees at local and national levels can standardize guidelines and practice policies to optimize patient safety and outcomes.
@article{goldsmithUltrasoundguidedNerveBlocks2024,
title = {Ultrasound-guided nerve blocks in emergency medicine practice: 2022 updates},
volume = {78},
issn = {1532-8171},
shorttitle = {Ultrasound-guided nerve blocks in emergency medicine practice},
doi = {10.1016/j.ajem.2023.12.043},
abstract = {OBJECTIVES: In the Emergency Department (ED), ultrasound-guided nerve blocks (UGNBs) have become a cornerstone of multimodal pain regimens. We investigated current national practices of UGNBs across academic medical center EDs, and how these trends have changed over time.
METHODS: We conducted a cross-sectional electronic survey of academic EDs with ultrasound fellowships across the United States. Twenty-item questionnaires exploring UGNB practice patterns, training, and complications were distributed between November 2021-June 2022. Data was manually curated, and descriptive statistics were performed. The survey results were then compared to results from Amini et al. 2016 UGNB survey to identify trends.
RESULTS: The response rate was 80.5\% (87 of 108 programs). One hundred percent of responding programs perform UGNB at their institutions, with 29\% (95\% confidence interval (CI), 20\%-39\%) performing at least 5 blocks monthly. Forearm UGNB are most commonly performed (96\% of programs (95\% CI, 93\%-100\%)). Pain control for fractures is the most common indication (84\%; 95\% CI, 76\%-91\%). Eighty-five percent (95\% CI, 77\%-92\%) of programs report at least 80\% of UGNB performed are effective. Eighty-five percent (95\% CI, 66\%-85\%) of programs have had no reported complications from UGNB performed by emergency providers at their institution. The remaining 15\% (95\% CI, 8\%-23\%) report an average of 1 complication annually.
CONCLUSIONS: All programs participating in our study report performing UGNB in their ED, which is a 16\% increase over the last 5 years. UGNB's are currently performed safely and effectively in the ED, however practice improvements can still be made. Creating multi-disciplinary committees at local and national levels can standardize guidelines and practice policies to optimize patient safety and outcomes.},
language = {eng},
journal = {The American Journal of Emergency Medicine},
author = {Goldsmith, Andrew J. and Brown, Joseph and Duggan, Nicole M. and Finkelberg, Tomer and Jowkar, Nick and Stegeman, Joseph and Riscinti, Matthew and Nagdev, Arun and Amini, Richard},
month = apr,
year = {2024},
keywords = {Cross-Sectional Studies, Emergency Medicine, Emergency Service, Hospital, Humans, Nerve Block, Nerve blocks, Opioid, Pain, Procedure, Regional anesthesia, Ultrasonography, Ultrasonography, Interventional, Ultrasound, United States},
pages = {112--119},
}
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METHODS: We conducted a cross-sectional electronic survey of academic EDs with ultrasound fellowships across the United States. Twenty-item questionnaires exploring UGNB practice patterns, training, and complications were distributed between November 2021-June 2022. Data was manually curated, and descriptive statistics were performed. The survey results were then compared to results from Amini et al. 2016 UGNB survey to identify trends. RESULTS: The response rate was 80.5% (87 of 108 programs). One hundred percent of responding programs perform UGNB at their institutions, with 29% (95% confidence interval (CI), 20%-39%) performing at least 5 blocks monthly. Forearm UGNB are most commonly performed (96% of programs (95% CI, 93%-100%)). Pain control for fractures is the most common indication (84%; 95% CI, 76%-91%). Eighty-five percent (95% CI, 77%-92%) of programs report at least 80% of UGNB performed are effective. Eighty-five percent (95% CI, 66%-85%) of programs have had no reported complications from UGNB performed by emergency providers at their institution. The remaining 15% (95% CI, 8%-23%) report an average of 1 complication annually. CONCLUSIONS: All programs participating in our study report performing UGNB in their ED, which is a 16% increase over the last 5 years. UGNB's are currently performed safely and effectively in the ED, however practice improvements can still be made. Creating multi-disciplinary committees at local and national levels can standardize guidelines and practice policies to optimize patient safety and outcomes.","language":"eng","journal":"The American Journal of Emergency Medicine","author":[{"propositions":[],"lastnames":["Goldsmith"],"firstnames":["Andrew","J."],"suffixes":[]},{"propositions":[],"lastnames":["Brown"],"firstnames":["Joseph"],"suffixes":[]},{"propositions":[],"lastnames":["Duggan"],"firstnames":["Nicole","M."],"suffixes":[]},{"propositions":[],"lastnames":["Finkelberg"],"firstnames":["Tomer"],"suffixes":[]},{"propositions":[],"lastnames":["Jowkar"],"firstnames":["Nick"],"suffixes":[]},{"propositions":[],"lastnames":["Stegeman"],"firstnames":["Joseph"],"suffixes":[]},{"propositions":[],"lastnames":["Riscinti"],"firstnames":["Matthew"],"suffixes":[]},{"propositions":[],"lastnames":["Nagdev"],"firstnames":["Arun"],"suffixes":[]},{"propositions":[],"lastnames":["Amini"],"firstnames":["Richard"],"suffixes":[]}],"month":"April","year":"2024","keywords":"Cross-Sectional Studies, Emergency Medicine, Emergency Service, Hospital, Humans, Nerve Block, Nerve blocks, Opioid, Pain, Procedure, Regional anesthesia, Ultrasonography, Ultrasonography, Interventional, Ultrasound, United States","pages":"112–119","bibtex":"@article{goldsmithUltrasoundguidedNerveBlocks2024,\n\ttitle = {Ultrasound-guided nerve blocks in emergency medicine practice: 2022 updates},\n\tvolume = {78},\n\tissn = {1532-8171},\n\tshorttitle = {Ultrasound-guided nerve blocks in emergency medicine practice},\n\tdoi = {10.1016/j.ajem.2023.12.043},\n\tabstract = {OBJECTIVES: In the Emergency Department (ED), ultrasound-guided nerve blocks (UGNBs) have become a cornerstone of multimodal pain regimens. We investigated current national practices of UGNBs across academic medical center EDs, and how these trends have changed over time.\nMETHODS: We conducted a cross-sectional electronic survey of academic EDs with ultrasound fellowships across the United States. Twenty-item questionnaires exploring UGNB practice patterns, training, and complications were distributed between November 2021-June 2022. Data was manually curated, and descriptive statistics were performed. The survey results were then compared to results from Amini et al. 2016 UGNB survey to identify trends.\nRESULTS: The response rate was 80.5\\% (87 of 108 programs). One hundred percent of responding programs perform UGNB at their institutions, with 29\\% (95\\% confidence interval (CI), 20\\%-39\\%) performing at least 5 blocks monthly. Forearm UGNB are most commonly performed (96\\% of programs (95\\% CI, 93\\%-100\\%)). Pain control for fractures is the most common indication (84\\%; 95\\% CI, 76\\%-91\\%). Eighty-five percent (95\\% CI, 77\\%-92\\%) of programs report at least 80\\% of UGNB performed are effective. Eighty-five percent (95\\% CI, 66\\%-85\\%) of programs have had no reported complications from UGNB performed by emergency providers at their institution. The remaining 15\\% (95\\% CI, 8\\%-23\\%) report an average of 1 complication annually.\nCONCLUSIONS: All programs participating in our study report performing UGNB in their ED, which is a 16\\% increase over the last 5 years. UGNB's are currently performed safely and effectively in the ED, however practice improvements can still be made. Creating multi-disciplinary committees at local and national levels can standardize guidelines and practice policies to optimize patient safety and outcomes.},\n\tlanguage = {eng},\n\tjournal = {The American Journal of Emergency Medicine},\n\tauthor = {Goldsmith, Andrew J. and Brown, Joseph and Duggan, Nicole M. and Finkelberg, Tomer and Jowkar, Nick and Stegeman, Joseph and Riscinti, Matthew and Nagdev, Arun and Amini, Richard},\n\tmonth = apr,\n\tyear = {2024},\n\tkeywords = {Cross-Sectional Studies, Emergency Medicine, Emergency Service, Hospital, Humans, Nerve Block, Nerve blocks, Opioid, Pain, Procedure, Regional anesthesia, Ultrasonography, Ultrasonography, Interventional, Ultrasound, United States},\n\tpages = {112--119},\n}\n\n\n\n\n\n\n\n\n\n\n\n","author_short":["Goldsmith, A. J.","Brown, J.","Duggan, N. 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