Digital Nerve Block: A Nurse Practitioner Guide to Local Anesthesia Infiltration

Digital Nerve Block: A Nurse Practitioner Guide to Local Anesthesia Infiltration is a focused, skills-based course designed to enhance the clinical competency of nurse practitioners in the performance of digital nerve blocks. This procedure is frequently indicated for laceration repair, fracture reduction, nail bed injuries, and minor surgical interventions involving the fingers and toes.

This course reviews the neuroanatomy of the digits, relevant surface landmarks, and the pharmacological agents commonly used for local infiltration. Emphasis is placed on patient selection, procedural technique, needle placement, volume dosing, and avoidance of complications such as vascular compromise or local anesthetic systemic toxicity (LAST). Proper documentation, informed consent, and post-procedural care are also discussed in accordance with best practice standards.

Topics covered include:

• Anatomy of the Digital Nerves: Detailed review of palmar and dorsal digital nerve pathways and associated vascular structures.
• Indications and Contraindications: Clinical scenarios where digital nerve blocks are appropriate and conditions that warrant caution or alternative interventions.
• Anesthetic Agents and Pharmacology: Overview of lidocaine, bupivacaine, and other agents, including onset, duration, and toxicology profiles.
• Step-by-Step Procedural Technique: Needle selection, hand positioning, site preparation, infiltration method, and safety precautions.
• Complication Recognition and Management: Identifying signs of intravascular injection, ischemia, infection, and managing adverse reactions.
• Patient Communication and Consent: Guidance on explaining the procedure, obtaining informed consent, and addressing patient concerns.
• Documentation Standards: Key elements to include in procedure notes, including agent used, site, volume, response, and follow-up instructions.
• Clinical Case Scenarios: Practical examples that illustrate common indications, challenges, and clinical decision-making in urgent care or outpatient settings.

Completion Requirements:

To receive full CE credit, participants must:

• Register for the course.
• Complete all course modules and assigned readings.
• Pass the post-test with a score of 70% or higher.
• Submit a completed course evaluation.

Optional reference tools include anatomic diagrams, dosage charts, and a digital nerve block checklist.

Important Disclosures:

• Conflict of Interest: Faculty and planners report no relevant financial relationships.
• Commercial Support: This activity received no external commercial funding or sponsorship.
• Non-Endorsement: Accreditation does not imply endorsement of any commercial products or companies.
• Off-Label Product Use: Any mention of off-label drug use is consistent with current clinical guidelines and evidence-based practice.