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Digital Nerve Block: Supplies and Procedure
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Slides Digital Nerve Block Supplies and Procedure.pdf
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Reference List Digital Nerve Block.pdf
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Download Lecture Overview
00:01 So now it's time to gather your supplies, prepare your work area, and perform hand washing. 00:08 You're going to need: 1 or 2% lidocaine (I would use caution with using lidocaine with epinephrine in it), 25 to 27 gauge needle, 3 to 5 cc syringe, your chlorohexidine or your Betadine (remember to check for allergies), sterile gauze, your marking pen, and gloves. 00:32 Because this procedure involves needles, you want to make sure that your patient is comfortable. You want to reduce that anxiety. 00:40 You want to complete and document your neurovascular exam which includes checking capillary refill sensation and motor function pre-procedure. And you want to mark the injection sites at the webbing spaces on the dorsal aspect. Identify proper landmarks of the base of the digit on both sides. 01:01 Prepare area with antiseptic solution using sterile technique and allow adequate drying time before proceeding. 01:10 These are some pictures looking at both the dorsal and the volar nerve intervention. 01:20 You're going to draw up 3 to 4 cc's of lidocaine. 01:24 And again use caution whether you use epinephrine in your lidocaine. 01:29 Insert the needle perpendicular to the skin at the dorsal webspace. 01:34 Advance to the appropriate depth about 5 to 10mm while aspirating. 01:39 Inject 1 to 1 .5 cc slowly while withdrawing the needle. And you're going to repeat this on the opposite side of the digit. 01:49 You're going to massage the area gently to distribute the anesthetic. 01:54 You're going to wait 5 or 10 minutes for full effect, and then you're going to proceed to the next procedure. 02:02 You're going to document post-procedure the neurovascular checks again. 02:07 You're going to compare to the pre-procedure exam findings of the neurovascular exam, which include checking the capillary refill, the sensation and motor function. 02:18 Remember that you may have 2 to 8 hours before they receive full sensation back after using the lidocaine.
About the Lecture
The lecture Digital Nerve Block: Supplies and Procedure by Glenna Lashley, FNP, MSN is from the course Primary Care Skills for Advanced Practice Providers.
Included Quiz Questions
Which of the following is NOT a required supply for performing a digital nerve block?
- 25-27 gauge needle
- 1-2% lidocaine
- Local heat pack
- Sterile gauze
- Chlorhexidine or Betadine
What is an important component of the pre-procedure exam that needs to be documented?
- Patch testing on area where injection is expected
- Check for cranial nerve deficits
- Use of point of care vein finder
- Capillary refill, sensation, and motor function
- X-ray (radiologic imaging) is required for all digital blocks
What is the correct technique for administering the anesthetic during a traditional digital nerve block?
- Insert needle at 30 degrees and inject 2-3cc rapidly to facilitate maximal absorption of the anesthetic
- Insert perpendicular to skin, aspirate (checking for blood), and inject 1-1.5cc slowly while withdrawing
- Insert needle parallel to the skin surface, and inject 3cc quickly to create a wheal
- Insert needle at the base of the finger and inject at least 5cc slowly to enhance the anesthetic effect
- Insert needle perpendicularly at the affected fingertip and inject 0.5 cc rapidly while redirecting the needle to right and then left to fully infiltrate the tissue
Author of lecture Digital Nerve Block: Supplies and Procedure
Glenna Lashley, FNP, MSN
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