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<br /> Philips emergency medicine<br /> ultrasound tutorial<br /> Ultrasound-guided ulnar nerve block for the<br /> management of 5th metacarpal fractures<br /> Michael B. Stone, MD, RDMS<br /> Department of Emergency Medicine<br /> Alameda County Medical Center –<br /> Highland General Hospital<br /> Arun Nagdev, MD<br /> Department of Emergency Medicine<br /> Alameda County Medical Center –<br /> Highland General Hospital<br /> Table of contents<br /> Ultrasound-guided ulnar nerve block for the<br /> management of 5th metacarpal fractures<br /> 1 Introduction ............................................................ 3<br /> 2 Clinical case ............................................................ 4<br /> 3 Anatomy .................................................................. 7<br /> 4 Ultrasound views – techniques .......................... 8<br /> 5 Ultrasound-guided block – technique ............ 14<br /> 6 Clinical pearls ...........................<a title="Ulnar Tutorial page 1" href="http://viewer.zmags.com/publication/473feaed?page=1"> Philips emergency medicine ultrasound tutorial Ul</a> <a title="Ulnar Tutorial page 2" href="http://viewer.zmags.com/publication/473feaed?page=2"> Table of contents Ultrasound-guided ulnar nerve </a> <a title="Ulnar Tutorial page 3" href="http://viewer.zmags.com/publication/473feaed?page=3"> 1 Introduction Emergency physicians often care f</a> <a title="Ulnar Tutorial page 4" href="http://viewer.zmags.com/publication/473feaed?page=4"> 2 Clinical case A young adult male presents to t</a> <a title="Ulnar Tutorial page 5" href="http://viewer.zmags.com/publication/473feaed?page=5"> Figure 1 Examination of the patient’s hand demons</a> <a title="Ulnar Tutorial page 6" href="http://viewer.zmags.com/publication/473feaed?page=6"> 2 Clinical case Figure</a> <a title="Ulnar Tutorial page 7" href="http://viewer.zmags.com/publication/473feaed?page=7"> 3 Anatomy The ulnar nerve travels in the volar c</a> <a title="Ulnar Tutorial page 8" href="http://viewer.zmags.com/publication/473feaed?page=8"> 4 Ultrasound views – technique Position the pati</a> <a title="Ulnar Tutorial page 9" href="http://viewer.zmags.com/publication/473feaed?page=9"> Figure 3 A high-frequency linear transducer is ap</a> <a title="Ulnar Tutorial page 10" href="http://viewer.zmags.com/publication/473feaed?page=10"> 4 Ultrasound views – technique </a> <a title="Ulnar Tutorial page 11" href="http://viewer.zmags.com/publication/473feaed?page=11"> First, identify the ulnar artery, which is easily</a> <a title="Ulnar Tutorial page 12" href="http://viewer.zmags.com/publication/473feaed?page=12"> 4 Ultrasound views – technique As the practitio</a> <a title="Ulnar Tutorial page 13" href="http://viewer.zmags.com/publication/473feaed?page=13"> Video 1 As the transducer is moved proximally up </a> <a title="Ulnar Tutorial page 14" href="http://viewer.zmags.com/publication/473feaed?page=14"> 5 Ultrasound-guided block technique Short-bevele</a> <a title="Ulnar Tutorial page 15" href="http://viewer.zmags.com/publication/473feaed?page=15"> Identify an appropriate location along the ulnar </a> <a title="Ulnar Tutorial page 16" href="http://viewer.zmags.com/publication/473feaed?page=16"> 5 Ultrasound-guided block technique </a> <a title="Ulnar Tutorial page 17" href="http://viewer.zmags.com/publication/473feaed?page=17"> Video 3 Local anesthetic is injected around the u</a> <a title="Ulnar Tutorial page 18" href="http://viewer.zmags.com/publication/473feaed?page=18"> 5 Ultrasound-guided block technique </a> <a title="Ulnar Tutorial page 19" href="http://viewer.zmags.com/publication/473feaed?page=19"> Video 5 This video is another example of an ultra</a> <a title="Ulnar Tutorial page 20" href="http://viewer.zmags.com/publication/473feaed?page=20"> 6 Clinical pearls Only inject anesthetic when th</a> <a title="Ulnar Tutorial page 21" href="http://viewer.zmags.com/publication/473feaed?page=21"> • Approaching the patient’s arm from the cephalad</a> <a title="Ulnar Tutorial page 22" href="http://viewer.zmags.com/publication/473feaed?page=22"> 7 Case resolution An ulnar nerve block is perfor</a> <a title="Ulnar Tutorial page 23" href="http://viewer.zmags.com/publication/473feaed?page=23"> Figure 6 Post-reduction oblique radiograph demons</a> <a title="Ulnar Tutorial page 24" href="http://viewer.zmags.com/publication/473feaed?page=24"> 8 Bibliography 1. Stone MB, Muresanu M. Ultraso</a> <a title="Ulnar Tutorial page 25" href="http://viewer.zmags.com/publication/473feaed?page=25"> Additional resources Additional resources relate</a> <a title="Ulnar Tutorial page 26" href="http://viewer.zmags.com/publication/473feaed?page=26"> Philips Healthcare is part of Royal Philips Elect</a>