Prospective Study of Ultrasound-Guided Regional Anesthesia Blocks for Upper Extremity Procedures in a Community Emergency Medicine Hospital

Painful upper extremity injuries frequently require procedures for which procedural sedation may be resource-intensive.This prospective study evaluated the educational impact and clinical feasibility of implementing a structured ultrasound-guided regional anesthesia curriculum as an alternative to procedural sedation for selected upper extremity procedures within a community emergency medicine residency.From January through December 2025, attending emergency physicians participated in a two-hour didactic session and hands-on workshop followed by longitudinal on-shift mentorship.Physician knowledge was assessed using a locally developed pre-and post-intervention cognitive assessment.Seventeen physicians completed the curriculum.Mean assessment scores increased from 8.18±3.05 to 18.41±1.58,with a mean improvement of 10.24 points (95% confidence interval (CI), 9.02-11.45;p<0.001).During clinical implementation, 30 ultrasound-guided brachial plexus blocks were performed.The intended procedure was completed without procedural sedation in 28 (93.3%)cases.In two (6.7%) cases, procedural sedation was subsequently required to complete the planned reduction.No immediate procedure-related complications were observed.A structured ultrasound-guided regional anesthesia curriculum was associated with improved physician knowledge and successful clinical implementation of brachial plexus blocks.These findings support the feasibility of incorporating ultrasound-guided regional anesthesia as an additional analgesic strategy for selected upper extremity procedures in a community emergency medicine setting.