Ischemic Arm Block for Closed Wrist Fractures-Ischemic Arm Block for Closed Wrist Fractures

Video Transcription

Video Summary

Dr. Sean Shopey presents on the ischemic arm block (Beers block or IVRA) for closed wrist fractures, highlighting its use in emergency departments. This technique involves applying a pneumatic tourniquet to halt blood flow, then injecting local anesthetic (typically prilocaine) into a vein, resulting in rapid pain relief and muscle relaxation ideal for manipulating distal radius and ulna fractures from falls. It offers advantages over sedation or general anesthesia by providing effective analgesia, a bloodless field, and faster patient recovery, enhancing emergency workflow. Safety is paramount; contraindications include allergy to anesthetics, severe hypertension, infection, sickle cell disease, and peripheral vascular issues. Proper setup requires consent, monitoring, dual IV access, and resuscitation readiness. The block takes about 25-30 minutes, achieves 90-95% success, and yields high patient satisfaction with minimal complications. Adherence to protocols ensures reproducibility and safety. Overall, the Beers block is a valuable, efficient, and patient-friendly option for managing closed wrist fractures in acute care.

Keywords

Ischemic arm block

Beers block

IVRA

Closed wrist fractures

Emergency department analgesia