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Prehospital Emergency Care Volume 16, 2012 - Issue 3
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Research Article

Paramedic-Performed Digital Nerve Block To Facilitate Field Reduction Of A Dislocated Finger

Paul M. SimpsonFrom the Ambulance Service of New South Wales (PMS, BM, JCB, DCC, PMM), New South Wales, Australia; the Discipline of Emergency Medicine, University of Sydney (PMM), Sydney, Australia; the Section of EMS, Department of Emergency Medicine (DCC), Yale University School of Medicine, New Haven, Connecticut; and the School of Public Health and Community Medicine, University of New South Wales (DCC, PMM), Sydney, Australia.Correspondence[email protected]
, MScM (ClinEpi), BEd, BHSc, ICP,
Bernadette McCabeFrom the Ambulance Service of New South Wales (PMS, BM, JCB, DCC, PMM), New South Wales, Australia; the Discipline of Emergency Medicine, University of Sydney (PMM), Sydney, Australia; the Section of EMS, Department of Emergency Medicine (DCC), Yale University School of Medicine, New Haven, Connecticut; and the School of Public Health and Community Medicine, University of New South Wales (DCC, PMM), Sydney, Australia.
, BHSc, BNurs, GradCert ICP,
Jason C. BendallFrom the Ambulance Service of New South Wales (PMS, BM, JCB, DCC, PMM), New South Wales, Australia; the Discipline of Emergency Medicine, University of Sydney (PMM), Sydney, Australia; the Section of EMS, Department of Emergency Medicine (DCC), Yale University School of Medicine, New Haven, Connecticut; and the School of Public Health and Community Medicine, University of New South Wales (DCC, PMM), Sydney, Australia.
, MBBS, MM (ClinEpi), PhD, ICP,
David C. ConeFrom the Ambulance Service of New South Wales (PMS, BM, JCB, DCC, PMM), New South Wales, Australia; the Discipline of Emergency Medicine, University of Sydney (PMM), Sydney, Australia; the Section of EMS, Department of Emergency Medicine (DCC), Yale University School of Medicine, New Haven, Connecticut; and the School of Public Health and Community Medicine, University of New South Wales (DCC, PMM), Sydney, Australia.
, MD &
Paul M. MiddletonFrom the Ambulance Service of New South Wales (PMS, BM, JCB, DCC, PMM), New South Wales, Australia; the Discipline of Emergency Medicine, University of Sydney (PMM), Sydney, Australia; the Section of EMS, Department of Emergency Medicine (DCC), Yale University School of Medicine, New Haven, Connecticut; and the School of Public Health and Community Medicine, University of New South Wales (DCC, PMM), Sydney, Australia.
, MBBS, MM (ClinEpi), MD
Pages 415-417 | Received 20 Dec 2011, Accepted 14 Jan 2012, Published online: 17 Apr 2012
 
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ABSTRACT

This short report describes the use of digital nerve block by a paramedic to facilitate the reduction of a dislocated finger in the prehospital setting. The finger was successfully reduced at the scene without requiring administration of parenteral opioids. The patient was reluctant to visit an emergency department, but was able to be referred to a local primary care practice for postreduction imaging and further care. Paramedic-performed local and regional anesthesia has not been previously described in the emergency medicine or emergency medical services literature. With appropriate training, prehospital digital nerve blocks may be a feasible option to supplement existing paramedic analgesic options.

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