A Nerve Block Team in the Emergency Department

Abstract

To improve pain management in the emergency department (ED), emergency physicians are performing an increasing number of ultrasound-guided regional anesthesia procedures (nerve blocks). We aimed to examine the effect of a dedicated emergency department (ED) nerve block team (NBT) on the number and types of ultrasound-guided nerve blocks administered in the ED. We performed a retrospective chart review comparing the nine-month period before and after the creation of a dedicated NBT. This was performed at a tertiary care urban hospital that is a level 1 trauma center. We assessed and compared the number and types of nerve blocks performed, level of learners who performed nerve blocks, and time of ED arrival to disposition, before and after implementation of the NBT. The utilization of nerve blocks rose from 79 prior to the establishment of the NBT to 108 following its creation, representing a 36.7% increase. The average duration of stay in the emergency department decreased by 51 minutes, though this change did not demonstrate statistical significance (P=0.1237). There was an increased variety in the types of nerve blocks performed. The introduction of a NBT led to a rise in both the quantity and diversity of nerve blocks conducted in the ED.