Building Blocks—A Block-by-Block Approach to Better Emergency Care in Children

Abstract

Abstract Regional anesthesia has gained prevalence over recent years in the emergency department setting, mainly in adults. Various frameworks have been suggested as toolkits encompassing the common procedures found in the adult setting. To date, no such framework exists for the pediatric emergency setting. Objective We describe a case series of regional nerve blocks, which comprise an adapted framework for the pediatric emergency setting and were performed by pediatric emergency medicine physicians. Methods A case series of 8 different ultrasound-guided nerve blocks and 1 anatomical block, performed in 11 pediatric patients, aged 7 weeks to 17 years. Results All blocks resulted in adequate analgesia. No procedural complications were observed. Conclusion We describe a set of nerve blocks performed by emergency medicine physicians in the pediatric population in an ED setting. In suitable settings, this is a safe and effective tool for procedural analgesia or for pain management. In such cases, performing an ultrasound-guided nerve block in the ED is a viable alternative for repeated doses of opiates, deep procedural sedation, or the operating theater. We propose this set of regional anesthesia procedures as a pediatric-adapted toolkit for the emergency physician to be performed in children in the ED setting. Adopting this set of procedures ensures better and safer care for children and provides a training framework for pediatric ED physicians.