Ultrasound-Guided Paravenous Saphenous Nerve Block for Lower Extremity Abscess Incision and Drainage in a Male Adolescent

Allen, Kelsey; Moake, Matthew M

doi:10.1097/pec.0000000000002768

Cited by 2 publications

(3 citation statements)

References 39 publications

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“…Nerve blocks are a core component of a multimodal pain management strategy and are useful for the management of several common emergency department (ED) presentations including fractures, laceration repair, and abscess incision and drainage. As opposed to using anatomic landmarks alone, the use of ultrasound-guidance for nerve blocks (UGNB) allows for needle tip visualization, increasing efficacy and analgesia, and decreases complications by allowing visualization of nearby vascular structures [59 ▪ ,60]. Although large studies about pediatric nerve blocks in the ED are limited, one recent retrospective review of US-guided femoral nerve blocks (Fig.…”

Section: High Yield Point-of-care Ultrasound-assisted Proceduresmentioning

confidence: 99%

“…Several recent case reports have described the use of UGNB's in the pediatric emergency department. Examples include the use of an ultrasound-guided paravenous saphenous nerve block to provide analgesia for incision and drainage of a medial lower leg abscess [60], a posterior tibial nerve block for foreign body removal from the plantar foot [62], and the use of an ultrasound-guided serratus anterior plane block for chest tube placement, rather than procedural sedation, in a patient with spontaneous pneumothorax [63].…”

Section: High Yield Point-of-care Ultrasound-assisted Proceduresmentioning

confidence: 99%

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Updates on the clinical integration of point-of-care ultrasound in pediatric emergency medicine

Lee,

Sweetnam-Holmes,

Soffer

et al. 2024

Current Opinion in Pediatrics

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Purpose of review There is expanding evidence for point-of-care ultrasound (POCUS) use in pediatric emergency medicine – this review highlights the benefits and challenges in the clinical integration of high-yield POCUS applications. Specifically, it will delve into POCUS applications during resuscitations, controversies of Focused Assessment with Sonography for Trauma (FAST) in pediatric trauma, POCUS-guided procedures, and examples of clinical pathways where POCUS can expedite definitive care. Recent findings POCUS can enhance diagnostic accuracy and aid in management of pediatric patients in shock and help identify reversible causes during cardiac arrest. The use of the FAST in pediatric blunt abdominal trauma remains nuanced – its proper use requires an integration with clinical findings and an appreciation of its limitations. POCUS has been shown to enhance safety and efficacy of procedures such as nerve blocks, incision & drainage, and intravenous access. Integrating POCUS into pathways for conditions such as intussusception and testicular torsion expedites downstream care. Summary POCUS enhances diagnostic efficiency and management in pediatric patients arriving at the ED with undifferentiated shock, cardiac arrest, or trauma. Additionally, POCUS improves procedural success and safety, and is integral to clinical pathways for expediting definitive care for various pediatric emergencies. Future research should continue to focus on the impact of POCUS on patient outcomes, ensuring user competency, and the expansion of POCUS into diverse settings.

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Section: High Yield Point-of-care Ultrasound-assisted Proceduresmentioning

confidence: 99%

Section: High Yield Point-of-care Ultrasound-assisted Proceduresmentioning

confidence: 99%

Updates on the clinical integration of point-of-care ultrasound in pediatric emergency medicine

Lee,

Sweetnam-Holmes,

Soffer

et al. 2024

Current Opinion in Pediatrics

View full text Add to dashboard Cite

show abstract

“…Many peripheral nerves are located superficially and, hence, are easily accessible for US examination. Although neurophysiological assessments are often considered the gold standard for peripheral nerve assessment [3], US-based techniques can be used as a complementary tool, providing anatomical information and localizing lesions more specifically [4], and providing additional data to guide clinical interventions [4][5][6][7]. Using US for peripheral nerve evaluation is advantageous compared to other imaging modalities, particularly in pediatric [4,8] and geriatric [9,10] populations, due to its rapid scanning capability and wide in-clinic availability.…”

Section: Introductionmentioning

confidence: 99%

Quantitative Ultrasound Techniques Used for Peripheral Nerve Assessment

et al. 2023

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Aim: This review article describes quantitative ultrasound (QUS) techniques and summarizes their strengths and limitations when applied to peripheral nerves. Methods: A systematic review was conducted on publications after 1990 in Google Scholar, Scopus, and PubMed databases. The search terms “peripheral nerve”, “quantitative ultrasound”, and “elastography ultrasound” were used to identify studies related to this investigation. Results: Based on this literature review, QUS investigations performed on peripheral nerves can be categorized into three main groups: (1) B-mode echogenicity measurements, which are affected by a variety of post-processing algorithms applied during image formation and in subsequent B-mode images; (2) ultrasound (US) elastography, which examines tissue stiffness or elasticity through modalities such as strain ultrasonography or shear wave elastography (SWE). With strain ultrasonography, induced tissue strain, caused by internal or external compression stimuli that distort the tissue, is measured by tracking detectable speckles in the B-mode images. In SWE, the propagation speed of shear waves, generated by externally applied mechanical vibrations or internal US “push pulse” stimuli, is measured to estimate tissue elasticity; (3) the characterization of raw backscattered ultrasound radiofrequency (RF) signals, which provide fundamental ultrasonic tissue parameters, such as the acoustic attenuation and backscattered coefficients, that reflect tissue composition and microstructural properties. Conclusions: QUS techniques allow the objective evaluation of peripheral nerves and reduce operator- or system-associated biases that can influence qualitative B-mode imaging. The application of QUS techniques to peripheral nerves, including their strengths and limitations, were described and discussed in this review to enhance clinical translation.

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Ultrasound-Guided Paravenous Saphenous Nerve Block for Lower Extremity Abscess Incision and Drainage in a Male Adolescent

Cited by 2 publications

References 39 publications

Updates on the clinical integration of point-of-care ultrasound in pediatric emergency medicine

Updates on the clinical integration of point-of-care ultrasound in pediatric emergency medicine

Quantitative Ultrasound Techniques Used for Peripheral Nerve Assessment

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