{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,13]],"date-time":"2026-09-13T09:54:44Z","timestamp":1789293284005,"version":"build-2803163510"},"reference-count":25,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pediatr Emer Care"],"published-print":{"date-parts":[[2019,1]]},"abstract":"\n Objectives<\/jats:title>\n Forearm fractures are among the most common pediatric injuries. Procedural sedation is frequently used for analgesia during fracture reduction but requires a prolonged recovery period and can be associated with adverse events. Bier block is a safe alternative for fracture reduction analgesia. This study sought to compare Bier block and procedural sedation for forearm fracture reduction.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n We performed a retrospective study of patients aged 6 to 18 years, presenting with forearm fractures requiring closed reduction from June 2012 to March 2014. Outcomes assessed were emergency department length of stay, reduction success rates, adverse events, and unscheduled return visits.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n Overall, 274 patients were included (Bier block, n = 109; procedural sedation, n = 165). Mean length of stay was 82 minutes shorter for Bier block patients (279 vs 361 minutes, P<\/jats:italic> < 0.001). Subanalysis revealed a reduced length of stay among Bier block patients with forearm fractures involving a single bone (286 vs 388 minutes, P<\/jats:italic> < 0.001) and both bones (259 vs 321 minutes, P<\/jats:italic> < 0.05). Reduction success did not differ between Bier block and procedural sedation (98.2% vs 97.6%, P<\/jats:italic> = 0.74). There were no major adverse events in either group, but Bier block patients experienced fewer minor adverse events (2.7% vs 14.5%, P<\/jats:italic> < 0.001). Return visit rates were similar between Bier block and procedural sedation (17.6% vs 16.9%, P<\/jats:italic> = 0.92).<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Compared with procedural sedation, forearm fracture reduction performed with Bier block was associated with a reduced emergency department length of stay and fewer adverse events, with no differences in reduction success or return visits.<\/jats:p>\n <\/jats:sec>","DOI":"10.1097\/pec.0000000000000963","type":"journal-article","created":{"date-parts":[[2016,12,1]],"date-time":"2016-12-01T13:54:01Z","timestamp":1480600441000},"page":"58-62","source":"Crossref","is-referenced-by-count":15,"title":["Reduced Length of Stay and Adverse Events Using Bier Block for Forearm Fracture Reduction in the Pediatric Emergency Department"],"prefix":"10.1097","volume":"35","author":[{"given":"Emmanuelle","family":"Fauteux-Lamarre","sequence":"first","affiliation":[{"name":"Department of Pediatric Emergency Medicine, The Montreal Children\u2019s Hospital, McGill University Health Center, Montreal, Quebec; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brett","family":"Burstein","sequence":"additional","affiliation":[{"name":"Department of Pediatric Emergency Medicine, The Montreal Children\u2019s Hospital, McGill University Health Center, Montreal, Quebec; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adam","family":"Cheng","sequence":"additional","affiliation":[{"name":"Section of Emergency Medicine, Department of Pediatrics, Alberta Children's Hospital, University of Calgary, Calgary, Alberta, Canada."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adam","family":"Bretholz","sequence":"additional","affiliation":[{"name":"Department of Pediatric Emergency Medicine, The Montreal Children\u2019s Hospital, McGill University Health Center, Montreal, Quebec; and"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"bib1-20230930","doi-asserted-by":"crossref","first-page":"1479","DOI":"10.1001\/jama.290.11.1479","article-title":"Incidence of childhood distal forearm fractures over 30 years: a population-based study","volume":"290","year":"2003","journal-title":"JAMA"},{"key":"bib2-20230930","doi-asserted-by":"crossref","first-page":"46","DOI":"10.1001\/archpedi.160.1.46","article-title":"Sedation and analgesia for pediatric fracture reduction in the emergency department: a systematic review","volume":"160","year":"2006","journal-title":"Arch Pediatr Adolesc Med"},{"key":"bib3-20230930","doi-asserted-by":"crossref","first-page":"209","DOI":"10.1097\/PEC.0b013e31803e1792","article-title":"The use of local anesthetic techniques for closed forearm fracture reduction in children: a survey of academic pediatric emergency departments","volume":"23","year":"2007","journal-title":"Pediatr Emerg Care"},{"key":"bib4-20230930","doi-asserted-by":"crossref","first-page":"449","DOI":"10.1016\/j.annemergmed.2010.11.030","article-title":"Clinical practice guideline for emergency department ketamine dissociative sedation: 2011 update","volume":"57","year":"2011","journal-title":"Ann Emerg Med"},{"key":"bib5-20230930","doi-asserted-by":"crossref","first-page":"241","DOI":"10.1111\/1742-6723.12074","article-title":"Procedural sedation and analgesia for reduction of distal forearm fractures in the paediatric emergency department: a clinical survey","volume":"25","year":"2013","journal-title":"Emerg Med Australas"},{"key":"bib6-20230930","doi-asserted-by":"crossref","first-page":"134","DOI":"10.1310\/hpj4802-134","article-title":"Adverse events associated with procedural sedation in pediatric patients in the emergency department","volume":"48","year":"2013","journal-title":"Hosp Pharm"},{"key":"bib7-20230930","doi-asserted-by":"crossref","first-page":"503","DOI":"10.1093\/pch\/8.8.503","article-title":"Procedural sedation and analgesia for paediatric patients in the emergency department","volume":"8","year":"2003","journal-title":"Paediatr Child Health"},{"key":"bib8-20230930","doi-asserted-by":"crossref","first-page":"1169","DOI":"10.1111\/j.1553-2712.2010.00917.x","article-title":"Closed reduction of distal forearm fractures by pediatric emergency physicians","volume":"17","year":"2010","journal-title":"Acad Emerg Med"},{"key":"bib9-20230930","first-page":"46","article-title":"Manipulation of simple paediatric forearm fractures: a time-based comparison of emergency department sedation with theatre-based anaesthesia","volume":"124","year":"2011","journal-title":"N Z Med J"},{"key":"bib10-20230930","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1136\/emj.2007.057208","article-title":"Paediatric distal radial fracture manipulation: multicentre analysis of process times","volume":"26","year":"2009","journal-title":"Emerg Med J"},{"key":"bib11-20230930","first-page":"299","article-title":"Intravenous regional anesthesia\u2014first century (1908\u20132008). 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