{
  "abstract": "Introduction Peripheral nerve blocks (PNBs) are an essential component of multimodal pain management strategies in trauma care. In modern practice, the addition of ultrasound (US) guidance has improved the safety, accuracy, and efficacy of these procedures. Civilian emergency departments and trauma systems are increasingly managing injuries similar to those seen in military settings, including complex fractures, amputations, and blast trauma. The influx of casualties in both civilian disasters and war-adjacent regions has blurred the lines between military and civilian trauma medicine. This has led to growing recognition of the need for all physicians—not just anesthesiologists—to be capable of providing ultrasound-guided PNBs in emergency settings. Methods We conducted a systematic literature review of articles published from January 2010 to May 2025 using PubMed, EMBASE, and Web of Science. The search strategy included terms such as ‘ultrasound-guided nerve block,’ ‘regional anesthesia,’ ‘trauma analgesia,’ ‘non-anesthesiologist,’ and ‘emergency medicine.’ Inclusion criteria focused on studies discussing the use of PNBs by civilian or non-specialist providers in trauma care, including randomized controlled trials, cohort studies, expert guidelines, and systematic reviews. Results Clinical Indications and Techniques PNBs can be adapted to a wide range of trauma situations. Fascia Iliaca Compartment Block (FICB) is effective for pelvic and femoral fractures, particularly in prehospital and ED settings. Interscalene and supraclavicular blocks are ideal for upper limb trauma. For lower limb injuries and amputations, the sciatic nerve block via the popliteal fossa is a proven option. The TAP block can be used for abdominal wall trauma or laparostomy pain. These techniques, when guided by ultrasound, can be applied safely even by non-anesthesiologists with adequate training. - Benefits of US Guidance Ultrasound enhances the precision of nerve localization and reduces the risk of vascular puncture or intraneural injection. Clinical trials show that US-guided PNBs result in faster analgesia onset, greater patient satisfaction, and reduced opioid requirements. In trauma patients, this enables safer evacuation, improved cooperation with diagnostics, and fewer complications from systemic analgesia. - Implementation Barriers Despite the benefits, barriers to wider implementation exist. Many civilian providers lack access to training programs. Fear of complications, lack of familiarity with ultrasound machines, and absence of standardized protocols further limit uptake. Simulation-based education and standardized trauma courses with PNB modules are essential to overcome these gaps. - Integration Into Civilian Trauma Systems There is a growing consensus among trauma specialists that regional anesthesia should be embedded into national trauma curricula. Countries with hybrid civilian-military medical systems (e.g., Ukraine, Israel) are pioneering this approach. In regions adjacent to conflict zones, civilian emergency departments are now de facto front-line facilities and require the same analgesic capabilities as combat field hospitals ( figure 1). Discussion The findings of this review strongly advocate for the strategic inclusion of ultrasound-guided peripheral nerve block (US-PNB) education within the training of all physicians managing trauma patients—not only anesthesiologists. In the context of modern trauma systems and wartime realities, where civilian medical professionals often provide frontline care, the ability to deliver safe and effective regional anesthesia has become a core clinical competency. Ultrasound-guided PNBs offer substantial advantages: precise pain control, lower systemic opioid use, and better conditions for patient triage and transport. However, these benefits can only be fully realized if medical personnel receive structured, practical training in sonoanatomy, needling techniques, and complication management. Simulation-based learning, integrated trauma courses, and point-of-care ultrasound education are effective means of addressing this need. Crucially, expanding access to PNB training also addresses equity and readiness in healthcare systems: rural hospitals, civilian emergency departments near conflict zones, and prehospital care teams are often under-resourced in terms of anesthetic support. Equipping general physicians, surgeons, and emergency doctors with PNB skills ensures timely and humane pain relief under austere conditions. Ultimately, the future of trauma care must include a multidisciplinary, education-centered model where US-PNBs are a standard, not a specialty. Abstract FT48 Figure 1Educational flow for integrating PNBs in civilian trauma careConclusion Ultrasound-guided peripheral nerve blocks are indispensable tools for modern trauma care. Their role in reducing pain, limiting opioid use, and enabling timely surgical intervention is well established. Civilian physicians, especially those in emergency and trauma environments, must be equipped with the skills and confidence to utilize these blocks. Institutional investment in education and protocols is required to make PNBs a standard of care across trauma systems.",
  "authors": [
    {
      "affiliations": [
        "Podilskiy Regional Center of Oncology, Vinnitsa, Ukraine"
      ],
      "name": "Dmytro Dmytriiev"
    }
  ],
  "title": "FT48 Ultrasound-guided peripheral nerve blocks for trauma patients: what civilian physicians need to know",
  "uid": "14176dc4-9210-5c4f-9f42-1748e012f3a6"
}