This series of USound guides are absolute gold. I am a GP and i work in remote Australia 1 week a month in ED. I am it essentially and these videos have been a life saver....thank you very much. Must have taken a lot of work to put these together. You are a champion...Liam
Hi Liam - thanks so much for taking the time to write. I am in awe of people like you who are so incredibly versatile and resourceful. Glad to be of some help. If there are other scenarios / topics that you are looking for answers to, please let me know, and if I have anything to offer, I will do my best to provide it. Cheers!
I started using U/S guidance for ankle blocks this year with the help of David Ayuong and Stuart Grant's USGRA book, but your video took it to the supreme level. Again, many thanks from North Dakota!
It's an amazing teaching video and much hard work put in with editing, live videos and pictures! A Question: Do you think this technique could be used in ED while reducing a dislocated and fractured (closed) ankle joint instead of using procedural sedation (PS)? The idea is to reduce costs and the need for staff and a place in the resuscitation area (we call it a bay with monitoring and airway equipment) in the ED for PS. I am based in the UK, where hospitals are facing severe financial difficulties. I would like to know if there is a way to reduce costs. Unlike the US, where EDs have fluoroscopes, we tend to reduce joints, plaster them, and send the patients for check XR to the XR department. Quite often, the Orthopods would not be happy with the post-reduction alignment and would want to reduce it again. In this case, arranging a repeat PS and a space in the resuscitation bay is not always easy. Or would an intra-articular hematoma block be more practical in ED. Your thoughts, please. Thank you
I’ve watched a number of your vids over the years, thanks so much for sharing your knowledge and techniques! This is particularly applicable to my new position as sole anesthesia provider at a podiatry ASC, and armed with this knowledge and a new handheld ultrasound I hope to do you proud 😉
Great video,especially tips for the oedematous patient (often make me want to give up1!). But, particularly enjoyed the dedication to TA who started me on my regional learning curve
Yes, it works very well, and US is particularly helpful for locating the nerves, which will be a lot deeper than expected, especially the subcutaneous ones. See the "Difficult Ankle" examples in the video.
we do not perform theses blocks at the ankle anymore. a little bit proximally in the leg is more comfortable and one skin puncture for superficial and deep peroneal nerve
I hadn't heard of it until now. Thanks for sharing! Looks interesting as a LMG technique. At present, I don't think that it will replace my current USG technique which I have personally evolved to the point of optimal safety and efficacy. Which illustrates the point that everyone should consider what works best for them in their setting, and in their hands.
00:07 - Indications / Advantages / Limitations
01:35 - Overview of the 5 nerves
02:12 - Preparation for the block
03:45 - Positioning the patient
04:40 - (1) TIBIAL nerve block
07:42 - Video - Tibial nerve block
08:34 - Challenging anatomy - Tibial nerve block
09:53 - (2) SAPHENOUS nerve block
10:45 - Video - Saphenous nerve block
11:31 - Challenging anatomy - Saphenous nerve block
12:13 - (3) DEEP PERONEAL nerve block
14:17 - Video - Deep peroneal nerve
15:08 - Challenging anatomy - Deep peroneal nerve
15:38 - (4) SUPERFICIAL PERONEAL nerve block
17:57 - Video - Superficial peroneal nerve block
18:56 - Challenging anatomy - Superficial peroneal nerve block
19:13 - (5) SURAL nerve block
20:43 - Video - Sural nerve block
21:30 - Challenging anatomy - Sural nerve block
This series of USound guides are absolute gold. I am a GP and i work in remote Australia 1 week a month in ED. I am it essentially and these videos have been a life saver....thank you very much. Must have taken a lot of work to put these together. You are a champion...Liam
Hi Liam - thanks so much for taking the time to write. I am in awe of people like you who are so incredibly versatile and resourceful. Glad to be of some help. If there are other scenarios / topics that you are looking for answers to, please let me know, and if I have anything to offer, I will do my best to provide it. Cheers!
I started using U/S guidance for ankle blocks this year with the help of David Ayuong and Stuart Grant's USGRA book, but your video took it to the supreme level.
Again, many thanks from North Dakota!
Great teaching! Much better than the rest that's available on this channel.
It's an amazing teaching video and much hard work put in with editing, live videos and pictures!
A Question: Do you think this technique could be used in ED while reducing a dislocated and fractured (closed) ankle joint instead of using procedural sedation (PS)? The idea is to reduce costs and the need for staff and a place in the resuscitation area (we call it a bay with monitoring and airway equipment) in the ED for PS. I am based in the UK, where hospitals are facing severe financial difficulties. I would like to know if there is a way to reduce costs. Unlike the US, where EDs have fluoroscopes, we tend to reduce joints, plaster them, and send the patients for check XR to the XR department. Quite often, the Orthopods would not be happy with the post-reduction alignment and would want to reduce it again. In this case, arranging a repeat PS and a space in the resuscitation bay is not always easy. Or would an intra-articular hematoma block be more practical in ED. Your thoughts, please. Thank you
I’ve watched a number of your vids over the years, thanks so much for sharing your knowledge and techniques! This is particularly applicable to my new position as sole anesthesia provider at a podiatry ASC, and armed with this knowledge and a new handheld ultrasound I hope to do you proud 😉
That's wonderful to hear! Good luck, and I'm sure you'll have lots of appreciative patients!
Great video,especially tips for the oedematous patient (often make me want to give up1!). But, particularly enjoyed the dedication to TA who started me on my regional learning curve
great videos , very educative! does it work in edema, as tissue is acidotic? thank you
Yes, it works very well, and US is particularly helpful for locating the nerves, which will be a lot deeper than expected, especially the subcutaneous ones. See the "Difficult Ankle" examples in the video.
Ankle TQ works out just fine too with an ankle block. Great vid btw.
Excellent rendition!
we do not perform theses blocks at the ankle anymore. a little bit proximally in the leg is more comfortable
and one skin puncture for superficial and deep peroneal nerve
Hi Olivier! Thanks for sharing - I will have a look to see, and give it a try.
Olivier, can you explain this more deeply, can you give the link to a video sounds very interessant, J Merk
I too would love more info about this technique-got a vid or link you can direct us to?
done yet sorry for the delay - big hugs from France :
th-cam.com/video/wHreXyOw_aU/w-d-xo.html
Very well.organized awesome lecture. Thank you so much
Are you familiar with the so called MAYO block?
I hadn't heard of it until now. Thanks for sharing! Looks interesting as a LMG technique. At present, I don't think that it will replace my current USG technique which I have personally evolved to the point of optimal safety and efficacy. Which illustrates the point that everyone should consider what works best for them in their setting, and in their hands.
GREAT PRESENTATION! THANK YOU VERY MUCH SIR!
Great video!!! Thank you!
AS USSUAL THE TOP .