Single palmar injection versus double injection dorsal digital nerve block for finger injuries in the Emergency Department: A Randomised Clinical Trial.

Which method of numbing finger injuries in the ED (a single palmar injection or a double injection dorsal digital nerve block) is least painful for the patient?

Grant ID: EMTR-12-179-MARTIN-DIGITAL

Project Summary

Patients with finger injuries often require their finger to be numb to allow their injury to be assessed properly and treated.
There are several methods available to numb the finger. Our study aims to compare two methods for numbing the patient’s finger to see which one of these methods is least painful for the patient. The first method is a single injection in the palm of the hand and the second method is two injections in the back of the hand or finger. The second method is the most commonly used method in our emergency department. Our hypothesis is that the single injection into the palm is less painful than the double injection in the back of the hand or finger.

Patients who present to the emergency department with finger injuries that require their finger to be numb for treatment or assessment of their injury will be given a study information sheet and consent will be obtained for participation in the study. Participants will then be randomly assigned to receive either the single injection in the palm or the double injection in the back of the hand or finger. A medical officer will perform the injection to numb the finger and a separate medical officer will then ask the patients to rate the pain of the injection to numb their finger. Participants will also be asked to rate their pain level before and five and ten minutes after the injection. The patient’s finger injuries will be treated as per standard care for their injury. Patients will be contacted at one week following the injection to ask them if they have any pain or signs of infection such as redness or swelling.

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Outcomes

A potential outcome of this investigation is an improvement in the pain management for patients presenting to the Emergency Department with finger injuries, through the comparison of two commonly used numbing methods.

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Dissemination

Martin, S.P., Chu, K.H., Mahmoud, I., Greenslade, J.H. and Brown, A.F., 2016. Double‐dorsal versus single‐volar digital subcutaneous anaesthetic injection for finger injuries in the emergency department: A randomised controlled trial. Emergency Medicine Australasia, 28(2), pp.193-198.

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