Bier's 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.