Podcast #243: Sphenopalatine Nerve Block

Podcast #243: Sphenopalatine Nerve Block

Author: Don Stader, M.D.

Educational Pearls

  • Cluster headaches are usually intense, unilateral, and involve the periorbital area.
  • CN V (Trigeminal) provides sensory and autonomic innervation the face and eyes, which play roles in headache pathology.
  • Cluster headaches can be treated with high flow oxygen, but a new treatment involves blocking the sphenopalatine ganglion (SPG) with lidocaine. Because sensory and autonomic branches of the trigeminal traverse the SPG, lidocaine will effectively treat a cluster headache.
  • To block the ganglion, intranasal lidocaine may be used, or a Q-tip soaked in 4% lidocaine can be applied to the most posterior aspect of the pharynx for 10-15 minutes.

References: https://www.aliem.com/2017/03/trick-sphenopalatine-ganglion-block-primary-headaches/

Jaksot(1147)

Podcast #210: Bear Mauling

Podcast #210: Bear Mauling

Author: Jared Scott M.D. Educational Pearls: Bear mauling is not a common issue in the ED. The Ursus americanus (black bear) is the most common in Colorado, but Ursus arctos horribilis (grizzly bear)...

28 Touko 20174min

Podcast #209: Rabbit Done Died

Podcast #209: Rabbit Done Died

Author: Sam Killian, M.D. Educational Pearls: "The Rabbit Has Died" is a lesser used phrase to denote finding out one is pregnant. During a test used in the 1930s, the "Rabbit's Test," a rabbit was i...

26 Touko 20176min

Podcast #208: Vocal Cord Dysfunction

Podcast #208: Vocal Cord Dysfunction

Author: Martin O'Bryan M.D. Educational Pearls: Vocal cord dysfunction can mimic other causes of stridor, such as asthma and upper airway obstruction. Patients are often very anxious because of the d...

24 Touko 20174min

Podcast #207: Boxer's Fracture

Podcast #207: Boxer's Fracture

Author: Sam Killian, M.D. Educational Pearls: Defined as fracture of neck (distal segment) of 5th metacarpal. Intrinsic muscles of hand pull segment to palmar aspect of hand. 30 degrees of angulation...

22 Touko 20174min

Podcast #206: Urethral Injuries

Podcast #206: Urethral Injuries

Author: Jared Scott, M.D. Educational Pearls: DDx for blood at urethral meatus includes: pelvic fracture, ruptured bladder, kidney laceration, penile trauma. Retrograde Urethrogram (RUG) must be perf...

20 Touko 20174min

Podcast #205: Post Cardiac Arrest Temperature Control

Podcast #205: Post Cardiac Arrest Temperature Control

Author: Michael Hunt, M.D. Educational Pearls: Research has shown that the higher temperatures post-cardiac arrests may lead to poorer outcomes. Initially, 33 deg C was the target temp. However, more...

18 Touko 20173min

Deep Dive #3: The New Standard in Stroke Treatment

Deep Dive #3: The New Standard in Stroke Treatment

Authors: Rebecca van Vliet MS, APN; Michelle Whaley MSN, CNS, CCNS, ANVP-VC The Stroke Team at Swedish Medical Center gives us a taste of how they are breaking records with door-to-needle time in man...

16 Touko 201738min

Podcast #204: Thoracotomy

Podcast #204: Thoracotomy

Author: Aaron Lessen M.D. Educational Pearls: Thoracotomy is a potentially life-saving procedure. However, outcomes are often poor and the procedure itself poses many risks to provider and patient....

14 Touko 20172min

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