Top Tweets for #EmergencyRa
Moultonborough, NH *SIGNAL 1000 (EMERGENCY RADIO TRAFFIC ONLY)* Area of center harbor town line- route 25 Moultonborough, NH, USA - Units have a vehicle stopped possible kidnapping in progress - 7/16/2026 21:57:12
26-24632-PD
#NH #Moultonborough #CarrollCounty #EmergencyRa…

"🛬 On-Arrival Regional Blocks: A Head-to-Toe Strategy for Early Pain Relief"
#OnArrivalBlock #RegionalAnesthesia
#AcutePainManagement #EmergencyRA #HeadToToeBlocks #TraumaPainRelief
#UltrasoundGuidedRA #PointOfCareBlocks
#GangaModel #PainFreeED #PreoperativeCare #BlockToBuildTrust #RAMatters #SmartBlockStrategy
#AnesthesiologyEducation #RAInTriage #FirstLinePainRelief #FromArrivalToRelief
#MEdTwitter #TipoftheDay #MyRATips
Tip of the Day:
📖INTRODUCTION:
🕐An On-Arrival Block: Early administration of a RA technique in the emergency department (ED) or triage area - typically done immediately upon patient arrival, before definitive surgical or procedural care begins.
🛡️The concept of the On-Arrival Block was introduced by 𝐆𝐚𝐧𝐠𝐚 𝐇𝐨𝐬𝐩𝐢𝐭𝐚𝐥, 𝐂𝐨𝐢𝐦𝐛𝐚𝐭𝐨𝐫𝐞, 𝐈𝐍𝐃𝐈𝐀, as an innovative approach to provide early RA in the emergency or triage setting - well before surgery or definitive care begins.
🎗️The goal is simple yet powerful: Treat pain at the DOOR, not the OR.
🎯PRIMARY GOALS:
🔥 Provide rapid and effective analgesia
💨 Improve respiratory mechanics (especially in chest trauma)
📷 Facilitate imaging and physical examination
🚑 Ease patient transfer and positioning
💉 Reduce opioid use and side effects
🫱 Build early rapport and trust with the patient
🤝 Promote cooperation throughout the perioperative course
✅ INDICATIONS:
🔥 Pain is severe and hinders exam, breathing, or movement
🧍♂️ Positioning is difficult (e.g., hip/femur injuries)
🫁 Breathing is compromised due to rib fractures or flail chest
🧠 Opioid-sparing strategies are beneficial (elderly, frail, respiratory risk)
⚠️ WHEN TO AVOID?
🧠 Head injuries needing serial neuro exams
🦴 Cervical spine trauma (await clearance)
💔 Cardiac tamponade, MI, aortic dissection
📉 Unexplained or ongoing hemorrhagic shock
🚨 Polytrauma with uncertain injury zones
🤕 Overlying infection or open wounds at block site
🧪 Coagulopathy or anticoagulation status unknown
🧰 TIPS FOR SAFETY:
🧼 No need for full OR sterility - basic aseptic precautions suffice
🩻 Ultrasound guidance improves safety and precision
📋 Always document the block: indication, technique, drugs, and patient response
🧭 Use blocks to facilitate care, not delay it
📋 PRE-REQUISITES:
✅ Rapid verbal consent (if possible)
🩸 Bleeding/clotting risk assessment
🩻 Ultrasound availability
🧼 Aseptic preparation with basic precautions (chlorhexidine, gloves, mask)
📋 Document site, drug, volume, technique, and response
🧰 IDEAL LOW-RISK BLOCKS:
🟩ESP Block — For chest, upper abdomen, flank
🟥Fascia Iliaca Block — For hip/femur pain
🟨SAP Block — For lateral chest wall trauma
🟦TAP Block — For anterior abdominal wall pain
🟫Adductor Canal Block — For anterior knee pain
🟪IIN/IHN Block — For groin or inguinal hernia
📌 FINAL PEARLS FOR SAFE PRACTICE:
🧼 No need for full OT sterility — basic aseptic technique is enough
🩻 Ultrasound-guided blocks preferred for accuracy and safety
🧾 Always document: indication, site, drugs used, and response
🚨 Use On-Arrival Blocks to improve care efficiency, not delay definitive treatment
🧩"Not every injury needs a block - 🦴 splinted limbs are quiet, but 🫁 breath and 🛏️ movement come first."🟦

Great tip from @DrAndrewDixon at @Radiopaedia #EmergencyRa. Find that subtle lower lobe consolidation, look for loss of pulm vessels behind the hemidiaphragm.

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