The interscalene block is right up there with the femoral block in regards to its utility in the ED.  Overall the neck is a high risk area with lots of vasculature and the nerve roots themselves are relatively vulnerable to needle injury.  That said this block is generally very shallow and can be effective with low volumes of local anesthetic.  For most shoulder reductions, deltoid I&Ds and proximal humerus fractures a nice block can be placed with 5mL.  Check out our curriculum HERE and below.  The video is posted HERE.

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Out-of-plane interscalene block with the needle tip kept well away from the spinal roots

Out-of-plane interscalene block with the needle tip kept well away from the spinal roots

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