Local Anaesthesia Toxicity (LAST)

The key in managing LAST is prevention. Know your dose, know your maximum dose, always aspirate prior to injection and ask patient about symptoms Lidocaine toxicity cardiovascular complications are typically preceded by neurological signs/symptoms. If these develop, stop administration, place patient on monitor and ready your antidote Bupivacaine toxicity can be sudden and catastrophic. If […]

Digital Blocks of the finger: One injection technique (Whetzel’s approach)

The center of the palmer digital crease on the volar surface is identified as the injection site. The hand is cleaned appropriately with betadine or chlorhexidine and a 25 gauge needle is inserted at the palmar digital crease penetrating through the flexor tendons to the bone. The needle is then withdrawn slowly while applying gentle […]

Easy pain management for distal radius fractures

  Hematoma blocks can be extremely effective as primary analgesia or an adjunct for patients who cannot tolerate aggressive sedation. Performing a hematoma block is pretty straightforward: Feel with your thumb where the fracture is. It’s typically an easily identified step-off. Next stick a needle in right at the fracture or just proximal to it. It’s […]

Emergency Medicine Kenya Foundation

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