Painless Incision and Drainage of a Large Foot Hematoma in the Emergency Department Using an Ultrasound-Guided...

Emergency physicians are frequently required to drain superficial hematomas in the emergency department (ED), although incision and drainage (I&D) procedures can often be quite painful for patients. Ultrasound-guided regional anesthesia may provide safe and effective analgesia to perform drainage of large skin hematomas in the ED.

We report the case of a 76-year-old man who presented to the ED with a large fluctuant swelling on the dorsum of his foot, subsequently found to be a large subcutaneous hematoma. He underwent an ultrasound-guided superficial peroneal nerve block, which facilitated painless I&D without any additional analgesics.

The ultrasound-guided superficial peroneal nerve block may allow emergency physicians to provide safe and effective analgesia for minimally invasive ED procedures on the dorsum of the foot, such as laceration repairs or drainage of superficial skin abscesses or hematomas.