Daily Em Pearl 4/16/12

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    Daily Em Pearl 4/16/12

    A 55yoM is BIBEMS after an MVC c/o RLE pain w/obvious deformity at the thigh. Distally he is NVI but is in excruciating pain. The portable plain film shows a mid shaft fracture. You order dilaudid but he’s still really uncomfortable. How can you help him?

     

    Do a femoral nerve block. You can use the ultrasound to visualize the infiltration of 20cc of bupivicaine around the femoral nerve. Also, we have a study going on here at Sinai, so you can page the researchers at 917.205.8474. If it’s off study hours, you can just do the block.

    There are lots of techniques.

    http://www.youtube.com/watch?v=BErkIwma4pg&feature=related

     

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