Legs – Bread & Butter Bedside Ultrasound

Posterior Tibial Nerve Block

This is another simple and safe block that is PERFECT for anesthesia of the bottom of the foot (think lacerations and foreign bodies). The nerve is easy to see and right next to the posterior tibial artery which is a great landmark. This is a great block for those without a lot of comfort/experience with blocks. Here is a nice 5 minute video from 5minsono.

Fascia Iliaca Block

While this can anesthetize a large portion of the leg, I recommend focusing on the one high-yield application that has a number of studies to support it – Hip Fracture. You can decrease systemic opioid use and decrease the side-effects that come with it – constipation, delirium etc. Here is a nice 5 minute video from 5minsono.

Does the patient have a DVT?

I use bedside ultrasound to look for DVT’s usually in sick patients (read: hypotensive, trying to die). Given easy access to radiology ultrasound, I usually order radiology comprehensive ultrasounds on most of the usual leg swelling patients that I see in the ED. 5minsono video here.