BIERS BLOCK - THE EXPERIENCE OF AUSTRALIAN EMERGENCY DEPARTMENTS

Objective: To describe the current use, effectiveness and safety of Bier's block within Australian emergency departments. Design: A review of clinical practice based on an opinion survey of directors of emergency departments. Participants: Directors of 120 private and public hospital emergency departments. Results: A response rate of 97% was achieved. Bier's block was used in 67% of Australian emergency departments. Emergency department medical staff performed the procedure in 83% of these hospitals. It was estimated that 7500 emergency department Bier's blocks were performed each year. Ninety-six per cent of respondents found Bier's block to produce adequate regional anaesthesia. Reported complications or adverse reactions were extremely rare. A wide variation in procedural approach was evident. Conclusions: Bier's block is a popular, reliable and relatively safe anaesthetic technique for use in emergency departments. Increased surveillance of local anaesthetic morbidity associated with the technique, as well as a standardisation of the procedure in the emergency department setting, are required.