Clear!!! In the exciting conclusion to our two-parter on blocks in emergency medicine, things get real as the co-hosts debate Arun and Andrew over the ideal block for hip fracture, a slick way to reduce a shoulder dislocation, cheeky femoral blocks, and the role of fascial plane blocks in the ED.

Links:

The sponsor of this episode is GE Healthcare Venue Family of Ultrasound Machines: https://tinyurl.com/gehealthcarevenue

Article on spontaneous reduction hip dislocation after PENG block: https://pubmed.ncbi.nlm.nih.gov/39781033/

Blockheads website: www.blockheads-em.com

5 Minute Sono: https://coreultrasound.com/5ms/

POCUS Atlas: https://www.thepocusatlas.com/

Amit and Jeff are joined by Dr. Robbie Erskine from Daaaarrby, UK, sharing his immense wealth of knowledge and experience (and which Bond film is his fave) on spinal anesthesia technique and how to make ambulatory spinals work for everyone!

Remember to email: info@pajunk.com and put "BILIH" in the subject line to receive a free set of Block Guru posters!

Link to the BJA Education article on neuraxial anesthesia in patients with challenging anatomy: https://www.bjaed.org/article/S2058-5349(23)00154-3/fulltext

Link to Robbie's review article on ambulatory spinal anesthesia:

https://www.bjaed.org/article/S2058-5349(19)30107-6/fulltext

Amit and Jeff are joined by two Emergency Medicine experts (and self-described Blockheads!) with a passion for keeping injured patients comfortable. Drs. Arun Nagdev and Andrew Goldsmith talk to us about the role of regional anesthesia in the ER, what blocks are high-impact, what exactly is meant by a "tube and lube rotation" for trainees, and more!

Link to the JAMA paper on regional anesthesia in the ER and complications: https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2826105

In part 2, Amit and Jeff tackle probe positioning, needle trajectory and something called Pawa's Pleural Groan...Why is the PVB poised to have a renaissance? Should we block one level? Every level? What's the risk of pneumothorax and should this block be done in anti coagulated patients? (spoiler: 2 out of 2 hosts say YES!) Join us for all this and more as we round out this in-depth discussion into one of our FAVE block techniques. Oh, and jokes. Always the jokes.

Link to the Cho study on paravertebral micro-CT anatomy:

https://pubmed.ncbi.nlm.nih.gov/33990438/

Link to the paper on intermittent bolus vs continuous infusion for PV catheters:

https://pubmed.ncbi.nlm.nih.gov/30674696/

In this episode, Amit and Jeff hold court while discussing the crown jewel of regional techniques, the paravertebral block. Join us for some controversies, debates and jokes while we give paravertebral anatomy and block technique the royal treatment.

Grab an eggnog & a mince pie or two and join Amit and Jeff for a frosty and festive finale to Season 2, featuring answers to some listener questions and a joyful round of dad jokes!

Links to things discussed:

University of Florida study on intercostobrachial nerve block: https://pubmed.ncbi.nlm.nih.gov/35308761/

Good paper explaining how regional anesthesia does NOT block ischemic pain: https://pubmed.ncbi.nlm.nih.gov/24102987/

Puzzling paper attributing acute compartment syndrome after tibial shaft fracture to a femoral nerve block: https://pubmed.ncbi.nlm.nih.gov/8636198/

RAUK algorithm for managing nerve injury: https://www.ra-uk.org/index.php/12-guidelines/266-ra-uk-algorithm-for-management-of-nerve-injury-associated-with-regional-anaesthesia

Sternal hematoma block with catheter: https://pubmed.ncbi.nlm.nih.gov/16988309/

Paper on rebound pain (it's not a thing btw): https://pubmed.ncbi.nlm.nih.gov/33390261/

In this engaging conclusion of our two-parter, we continue to share some laughs with the amazing Tanya Selak while discussing the value of SoMe collaboration, how to set boundaries when things get rough, and why she's NOT quitting Twitter (X) quite yet. In the meantime, Amit quotes Vanilla Ice, while Tanya seeks redemption as she gets another shot at the Dad-joke title.

Dope beats & phat lyrics...just two audacious dad MCs sharing the podcast origin story over some laid back West-coast flow.