Upper Extremity Nerve Blocks
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| Spread of block is r/t? | show 🗑
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| Which will be blocked 1st in a brachial plexus block, proximal or distal? | show 🗑
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| show | Roots, trunks, divisions, cords, branches
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| show | Push, Pull, Pinch, Pinch
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| show | Push tests the radial nerve which innervates the triceps muscle
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| What does "pull" test for in a brachial plexus block? | show 🗑
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| show | One pinch to the pinky test the ulnar nerve and one pinch to the index finger tests the medial nerve.
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| show | Radial nerve.
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| show | There is a high risk for phrenic nerve block (unilateral). This is usually of little consequence in healthy patients but can lead to respiratory distress in patients who already have a comprimised resp status.
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| What type of surgeries is an interscaline block good for? | show 🗑
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| show | 6-8 hours of surgical anesthesia with up to 24 hours post-op pain relief.
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| show | The level of the trunks (superior, inferior, and middle)
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| show | The cricoid cartilage is at the level of C6, which serves as a guide when preforming an interscalene block.
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| Two "NEVERS" for an interscalene block | show 🗑
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| Needle insertion site for interscalene block. | show 🗑
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| Potential complications of interscalene block. | show 🗑
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| show | This can be prevented by monitoring for muscular response to current intensity less than 0.2mA. If this occurs, pull needls back slightly until the same response requires more than 0.2mA.
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| show | This can happen with a interscalene block as result of block spread to the stelate ganglion. Will result in ptosis, miosis, anhydrosis, increased skin temp, nasal congestion. This occurs less commonly with low interscalene block.
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| Needle size for interscalene block | show 🗑
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| show | Ulnar nerve
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| show | 6-8 hours of surgical anesthesia and up to 24 hours of postop analgesia
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| Goal of nerve stim during interscalene block | show 🗑
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| LA injection for interscalene block | show 🗑
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| How long for interscalene block to set up? | show 🗑
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| Wh is a supraclavicular block "better" than an interscalene block? | show 🗑
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| show | Pneumothorax 1-6%, infxn, hematoma
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| show | Musculocutaneous nerve will not be blocked by an axillary block and must be blocked seperately.
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| show | By injecting 5cc of LA into the corachobracialis muscle
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| Volume of LA for ax block | show 🗑
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| Three ways to preform an ax block | show 🗑
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| Intercostal block contraindications | show 🗑
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| Anatomy of intercostal block | show 🗑
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| Needle size for intercostal block | show 🗑
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| Volume of LA for intercostal nerve block | show 🗑
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| DOA of intercostal nerve block and type of LA | show 🗑
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| show | Inject 1-2ml of LA in medial & lateral aspect of digit with a 25g 1 1/2 in needle. Easier to do with hand pronated. Inject and form wheal on insertion and then direct needle anterioraly until phalanx is encoutered or ventral skin begins to tent.
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| Complications of digital nerve block | show 🗑
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| Ulnar nerve block at the wrist | show 🗑
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| Median Nerve Block at the wrist | show 🗑
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| show | Radial nerve at this level has already divided into many branches and requires a field block of radial aspect of wrist. It may require 5-6ml of LA and is not often used.
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| Disadvantages of intercostal block | show 🗑
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| show | Superior analgesia, opioid sparing, improved pulm mechanics, reduced CNS depression, Avoid urinary retention
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| Ax block nerve stimulator settings | show 🗑
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| Ax block continuous catheter infusion | show 🗑
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Created by:
mandyrosern
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