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Wavelength Academy · Nerve blocks

Ultrasound-guided blocks for the hand: median, ulnar, radial and digital

Hand injuries are among the commonest emergency department procedures. Learn to block the median, ulnar and superficial radial nerves in the forearm and the digital nerves in the finger with ultrasound, using small volumes, after a careful examination and within a safe system.

  • 1.5 hours CPD
  • 5 lessons
  • 5 cases
  • 14-question assessment
  • Pass mark 80%
  • Free

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What you will learn

  • Examine and document hand nerve and tendon function before any block
  • Set up a safe block: consent, dose calculation, monitoring, Stop Before You Block and documentation
  • Find the median, ulnar and superficial radial nerves in the forearm and tell them from tendons and vessels
  • Choose the right block, or combination, for a wound from the sensory map of the hand
  • Perform an ultrasound-guided digital block with small paired deposits

Lessons

  1. Why block the hand, and the examination first12 min
  2. The safety system: dose, Stop Before You Block and toxicity18 min
  3. The median nerve in the forearm14 min
  4. The ulnar and superficial radial nerves15 min
  5. The digital nerve block12 min
  6. Cases10 min
  7. Final assessment: 14 questions, pass mark 80%8 min

Who it is for

Emergency and acute care doctors, advanced clinical practitioners and emergency nurse practitioners who perform, or are training to perform, ultrasound-guided blocks for hand procedures under their trust's governance.

Your certificate

Pass the assessment and we email your certificate as a PDF: your name, the module, 1.5 hours of CPD, the date and a code anyone can check at thewavelength.co.uk/elearning/verify. Upload it to your e-portfolio with a short reflection. Wavelength issues the certificate itself. It is not accredited by an external body, so record the hours as self-directed CPD under your own college or regulator's rules. The certificate records completed learning. Sign-off to scan independently stays with your department.

About this module

Author. Dr Firas Abou-Auda, Consultant in Emergency Medicine and Course Director, Wavelength.
Published. October 2026. Next review. October 2028.
Conflicts of interest. Dr Firas Abou-Auda is Course Director of Wavelength, which runs paid ultrasound courses.

References

  1. Liebmann O, Price D, Mills C, et al. Feasibility of forearm ultrasonography-guided nerve blocks of the radial, ulnar, and median nerves for hand procedures in the emergency department. Annals of Emergency Medicine. 2006;48:558-62.
  2. McCahon RA, Bedforth NM. Peripheral nerve block at the elbow and wrist. Continuing Education in Anaesthesia, Critical Care and Pain. 2007;7:42-4.
  3. Lalonde D, Bell M, Benoit P, et al. A multicenter prospective study of 3,110 consecutive cases of elective epinephrine use in the fingers and hand: the Dalhousie Project clinical phase. Journal of Hand Surgery (American). 2005;30:1061-7.
  4. Association of Anaesthetists. Management of severe local anaesthetic toxicity. Safety guideline. 2010.
  5. Regional Anaesthesia UK and the Safe Anaesthesia Liaison Group. Stop Before You Block.

Read the free Wavelength Pearl on this topic