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‘Plan A’ for ultrasound-guided regional anaesthesia in the Emergency Department
  1. David Burckett-St Laurent1,
  2. David Metcalfe2,3,
  3. Elliot Sutcliffe4,
  4. Christopher Yap5
  1. 1 Department of Anaesthesia, Royal Cornwall Hospitals NHS Trust, Truro, UK
  2. 2 Oxford Trauma and Emergency Care (OxTEC), University of Oxford, Oxford, UK
  3. 3 Emergency Medicine Research in Oxford (EMROx), John Radcliffe Hospital, Oxford, UK
  4. 4 Emergency Department, Royal Cornwall Hospitals NHS Trust, Truro, UK
  5. 5 Emergency Department, Northern General Hospital, Sheffield, UK
  1. Correspondence to Dr David Metcalfe, Oxford Trauma and Emergency Care (OxTEC), University of Oxford, Oxford OX3 9DU, UK; david.metcalfe{at}

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Emergency physicians are increasingly familiar with point-of-care ultrasound (POCUS) as an adjunct to clinical examination. Although once the preserve of a small number of enthusiasts, POCUS is now a fundamental part of practising emergency medicine. Unsurprisingly, this shift has been accompanied by advances in portable ultrasound devices and the emergence of formal governance structures, such as dedicated fellowship training in POCUS, curriculum sign-offs and ED ultrasound subspecialty leads.

The Sono Case Series has been a popular feature of the EMJ for several years. In this issue, Graglia and Kornblith use a case-based approach to describe the superficial cervical plexus block.1 Their article helpfully illustrates some of the important principles and practical tips for delivering ultrasound-guided regional anaesthesia (UGRA) in the ED. It is also a timely reminder that ultrasound offers opportunities in the emergency setting beyond diagnosis, vascular access and real-time haemodynamic monitoring.

With the possible exception of the fascia iliaca compartment block, UGRA is underused in the ED, even though these techniques can achieve effective analgesia and facilitate procedures that might otherwise require intravenous sedation.2 There are many blocks that could have utility in the acute setting, such as the erector …

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  • Handling editor Caroline Leech

  • Twitter @TraumaDataDoc, @casualtysrus

  • Contributors DB-SL initiated the draft which was critically revised by DM, ES and CY. All authors were involved in the initial concept and approved the final version.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests DB-SL is a Clinical Consultant for Intelligent Ultrasound (Cardiff, UK).

  • Provenance and peer review Not commissioned; internally peer reviewed.

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