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ForwardUltrasound Guided Nerve Block Workshop
1. Demonstrate Proficiency in Performing Ultrasound-Guided Nerve Blocks
successfully identify relevant sonoanatomy and perform nerve blocks for upper
extremity, lower extremity, and truncal regions using ultrasound guidance.
2. Improve Accuracy and Confidence in Needle Guidance Techniques
Apply safe and effective needle insertion techniques while minimizing risks of
complications such as vascular injury or intraneural injection
.
3. Enhance Clinical Decision-Making in Nerve Block Selection
Select the most appropriate nerve block technique based on patient presentation,
surgical needs, and multimodal analgesia strategies.
4. Recognize and Address Potential Complications of Nerve Blocks Identify and troubleshoot common challenges, including poor anesthetic spread,
intravascular injection, and block failure.
5. Integrate Ultrasound-Guided Nerve Blocks into Clinical Practice
Effectively incorporate nerve blocks into emergency, surgical, and pain
management settings, improving patient outcomes and procedural efficiency.
Target Audience
Physicians
Learning Objectives
Introduction to Nerve Blocks
1. Explain the basic principles and mechanisms of ultrasound-guided nerve blocks.
2. Identify the key indications and contraindications for performing nerve blocks.
3. Discuss the advantages of ultrasound guidance over landmark-based techniques for nerve blocks.
Upper Extremity 1: Forearm Nerve Blocks
1. Describe the relevant anatomical structures involved in forearm nerve blocks.
2. Identify common clinical indications for forearm nerve blocks in pain management.
3. Explain the appropriate technique for performing ultrasound-guided forearm nerve blocks
.
Practice Session: Forearm Nerve Block Anatomy
1. Demonstrate correct ultrasound probe positioning for visualizing forearm nerve structures.
2. Perform needle guidance techniques for safe and effective forearm nerve blocks.
3. Recognize potential complications and troubleshoot technical challenges in forearm blocks.
Upper Extremity 2: Brachial Plexus Nerve Blocks
1. Describe the anatomical components of the brachial plexus relevant to nerve block procedures.
2. Differentiate between the various approaches to brachial plexus nerve blocks (e.g.,
supraclavicular, interscalene, axillary).
3. Explain the clinical indications and patient selection criteria for brachial plexus blocks.
Practice Session: Brachial Plexus Nerve Block Anatomy
1. Identify the sonographic appearance of the brachial plexus at different levels.
2. Practice ultrasound-guided needle placement for brachial plexus nerve blocks.
3. Evaluate and adjust techniques to optimize local anesthetic spread and effectiveness.
Truncal Blocks
1. Describe the anatomical structures involved in common truncal nerve blocks (e.g., TAP block,
Serratus Anterior).
2. Discuss the indications and contraindications for truncal nerve blocks.
3. Compare the effectiveness of truncal blocks for different types of surgical and trauma-related
pain.
Practice Session: Truncal Nerve Block Anatomy
1. Identify sonoanatomy relevant to truncal blocks using ultrasound imaging.
2. Demonstrate appropriate needle guidance techniques for truncal nerve blocks.
3. Recognize potential complications and strategies for improving block efficacy.
Lower Extremity Nerve Blocks
1. Describe the relevant anatomical landmarks and nerve distributions for lower extremity blocks.
2. Discuss the indications for femoral, sciatic, and popliteal nerve blocks.
3. Explain the role of lower extremity nerve blocks in multimodal analgesia strategies.
Practice Session: Lower Extremity Nerve Block Anatomy
1. Identify lower extremity nerves using ultrasound imaging.
2. Demonstrate proper needle insertion and local anesthetic delivery for lower extremity blocks.
3. Adjust positioning and technique to optimize block success while minimizing complications
Introduction to Nerve Blocks (8:00 - 8:30 AM)
1. Explain the basic principles and mechanisms of ultrasound-guided nerve blocks.
2. Identify the key indications and contraindications for performing nerve blocks.
3. Discuss the advantages of ultrasound guidance over landmark-based techniques for nerve blocks.
Upper Extremity 1: Forearm Nerve Blocks (8:30 - 9:00 AM)
1. Describe the relevant anatomical structures involved in forearm nerve blocks.
2. Identify common clinical indications for forearm nerve blocks in pain management.
3. Explain the appropriate technique for performing ultrasound-guided forearm nerve blocks.
Practice Session: Forearm Nerve Block Anatomy (9:00 - 9:45 AM)
1. Demonstrate correct ultrasound probe positioning for visualizing forearm nerve structures.
2. Perform needle guidance techniques for safe and effective forearm nerve blocks.
3. Recognize potential complications and troubleshoot technical challenges in forearm blocks.
Upper Extremity 2: Brachial Plexus Nerve Blocks (10:00 - 10:30 AM)
1. Describe the anatomical components of the brachial plexus relevant to nerve block procedures.
2. Differentiate between the various approaches to brachial plexus nerve blocks (e.g.,
supraclavicular, interscalene, axillary).
3. Explain the clinical indications and patient selection criteria for brachial plexus blocks.
Practice Session: Brachial Plexus Nerve Block Anatomy (10:30 - 11:15 AM)
1. Identify the sonographic appearance of the brachial plexus at different levels.
2. Practice ultrasound-guided needle placement for brachial plexus nerve blocks.
3. Evaluate and adjust techniques to optimize local anesthetic spread and effectiveness.
Truncal Blocks (11:15 - 11:45 AM)
1. Describe the anatomical structures involved in common truncal nerve blocks (e.g., TAP block,
Serratus Anterior).
2. Discuss the indications and contraindications for truncal nerve blocks.
3. Compare the effectiveness of truncal blocks for different types of surgical and trauma-related
pain.
Practice Session: Truncal Nerve Block Anatomy (11:45 - 12:30 PM)
1. Identify sonoanatomy relevant to truncal blocks using ultrasound imaging.
2. Demonstrate appropriate needle guidance techniques for truncal nerve blocks.
3. Recognize potential complications and strategies for improving block efficacy.
Lower Extremity Nerve Blocks (1:00 - 1:30 PM)
1. Describe the relevant anatomical landmarks and nerve distributions for lower extremity blocks.
2. Discuss the indications for femoral, sciatic, and popliteal nerve blocks.
3. Explain the role of lower extremity nerve blocks in multimodal analgesia strategies.
Practice Session: Lower Extremity Nerve Block Anatomy (1:30 - 2:15 PM)
1. Identify lower extremity nerves using ultrasound imaging.
2. Demonstrate proper needle insertion and local anesthetic delivery for lower extremity blocks.
3. Adjust positioning and technique to optimize block success while minimizing complications.
Block Practice with Meat Models and Task Trainers (2:30 - 4:30 PM)
Station 1: Upper Extremity (Brachial Plexus Blocks)
1. Practice supraclavicular, interscalene, and axillary brachial plexus blocks using ultrasound
guidance.
2. Adjust transducer positioning to enhance visualization of nerve structures.
3. Demonstrate safe needle insertion techniques to avoid vascular injury.
Station 2: Truncal Blocks
1. Perform ultrasound-guided truncal nerve blocks on simulated models.
2. Assess needle placement and local anesthetic spread in real-time.
3. Identify and troubleshoot common technical challenges in truncal block placement.
Station 3: Lower Extremity Nerve Blocks
1. Utilize task trainers to practice femoral, sciatic, and popliteal nerve blocks.
2. Recognize the sonoanatomy of key lower extremity nerves.
3. Adjust needle positioning to maximize anesthetic distribution and minimize complications.
Station 4: Miscellaneous Practice (Forearm Blocks, PAJUNK Representative)
1. Reinforce proper ultrasound techniques for various nerve block procedures.
2. Describe the latest innovations in nerve block technology.
3. Apply learned skills in a hands-on, supervised environment to build confidence.
Wrap-Up, Feedback, and Questions (4:30 - 4:45 PM)
1. Reflect on the key takeaways from each session and identify areas for further improvement.
2. Discuss clinical applications and strategies for integrating nerve blocks into everyday practice.
3. Receive expert feedback and address any remaining questions about ultrasound-guided nerve
blocks.
Dr. Susannah Boulet is the Ultrasound Director at Forbes and Jefferson Emergency Departments. She completed her ultrasound fellowship at Brown University, following her residency in Emergency Medicine at Allegheny Health – St. Vincent’s Hospital. She earned her medical degree from Lake Erie College of Osteopathic Medicine (LECOM). With a strong passion for point-of-care ultrasound, Dr. Boulet is dedicated to advancing bedside imaging and education in emergency medicine.
Dr. Mark Scheatzle has served as the Ultrasound Division Director at Allegheny General Hospital since 2015 and has led the Advanced Emergency Ultrasound Fellowship program as Director since 2013. With over two decades of specialization in advanced emergency ultrasound, he was among the inaugural class to receive the Focused Practice Designation in Advanced Emergency Ultrasound from the American Board of Emergency Medicine in 2022. His dedication to education and clinical excellence has earned him notable recognition, including the Golden Apple Teaching Award from the Allegheny General Hospital Emergency Medicine Residency and the USACS Faculty Academic Award in 2022.
Dr. John Bowling has a robust background in EM ultrasound and ultrasound-guided nerve blocks. After completing a residency in EM at Cleveland Clinic Akron General, Dr. Bowling pursued a fellowship in ultrasound at Allegheny General Hospital in Pittsburgh. Currently, Dr. Bowling serves as the Ultrasound Director at AHN Grove City Hospital and teaches residents at Allegheny General Hospital in Pittsburgh, PA. He is an expert in ultrasound-guided nerve block, and has shared his knowledge nationally, teaching courses at the national ACEP conference and with OH ACEP
Dr. Jared Mugfor completed his Emergency Medicine residency at Allegheny General Hospital, graduating in 2023. Following residency, he completed a Medical Simulation fellowship at Rhode Island Hospital/Brown University. He is the simulation director and core faculty member for the Allegheny General EM residency. His professional interests include telesimulation and faculty clinical education.
This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education.
The Center for Emergency Medical Education is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.”
The Center for Emergency Medical Education designates this live activity for a maximum of 7.75 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.