RCEM Regional Anaesthesia

Emergency Medicine
Regional Blocks

Comprehensive reference for ultrasound-guided regional anaesthesia in emergency medicine. Indications, drug doses, complications and clinical pearls for every major block.

Ultrasound-GuidedRCEM GuidelinesDrug DosesLA Toxicity50-Question Quiz
6Nerve blocks
7LA agents
50SBA questions
RCEMEducation partner
Block 01

Serratus Anterior

Lateral chest wall T2–T9 dermatomes (mid-axillary line distribution).

Onset15–25 minutes for full sensory block
Duration8–18 hours (bupivacaine/levobupivacaine)
Block 02

Erector Spinae

Somatic: ipsilateral posterior and lateral chest/abdominal wall over multiple dermatomal levels (typically 4–6 levels caudal to injection).

Onset20–30 minutes for sensory block
Duration10–18 hours single injection
Block 03

Fascia Iliaca

Femoral nerve: anterior thigh and medial lower leg (saphenous nerve).

Onset15–30 minutes for full block
Duration12–18 hours with levobupivacaine 0.25%
Block 04

Femoral Nerve

Anterior and medial thigh (femoral nerve proper).

Onset10–20 minutes sensory block
Duration8–24 hours (bupivacaine/levobupivacaine 0.5%)
Block 05

Ankle Block

Tibial nerve: heel, plantar foot, toes 1–5 (sole).

Onset15–30 minutes for complete block
Duration8–12 hours with bupivacaine 0.5%
Block 06

Popliteal / Sciatic

Tibial nerve: plantar foot, heel, posterior leg.

Onset20–30 minutes for complete block
Duration14–24 hours with bupivacaine/levobupivacaine
Reference

LA Drugs

Comprehensive local anaesthetic drug reference including doses, pharmacokinetics, and adjuvants.

Agents7 drugs covered
Emergency

LA Toxicity

Recognition and management of LAST including 20% Intralipid protocol and resuscitation guidance.

Antidote20% Intralipid
Patient Safety

Stop Before You Block

Pre-block safety checklist and the final pause that prevents wrong-site regional anaesthesia — a Never Event.

CheckSite, side & dose
Assessment

SBA Quiz

50 single best answer questions covering all blocks, LA toxicity, and drug pharmacology.

Questions50 SBAs
Clinical Disclaimer

This resource is for educational purposes only. Drug doses and techniques should be verified against current national guidelines, the BNF, and local protocols before clinical use. All regional anaesthesia should be performed by appropriately trained practitioners with resuscitation equipment and 20% Intralipid readily available. In doubt, seek senior/anaesthetic support.