Overview

4.7 out of 5 (130 Reviews)

Credits

1.00

Post-Assessment Questions

8

Start Date

1 Sep 2023

Last Review Date

13 Dec 2025

Expiration Date

31 Aug 2026

Estimated Time To Finish

60 Minutes


Unlimited Physician CME

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Activity Description

Intravenous regional anesthesia (IVRA), or Bier block, is a long-established anesthetic technique for short surgical procedures and managing extremity pain. The method involves administering a local anesthetic into the venous system of an isolated limb after tourniquet application, resulting in rapid, reversible anesthesia. IVRA remains valuable in outpatient, perioperative, and emergency settings due to its simplicity, effectiveness, and minimal equipment needs. Safe use requires substantial knowledge of anatomy, pharmacology, patient selection, and technique. Complications such as local anesthetic systemic toxicity, methemoglobinemia, and tourniquet injury necessitate vigilance and readiness for immediate management. Innovations such as forearm tourniquet placement and adjunctive medications, including ketorolac, dexmedetomidine, and ketamine, enhance comfort, extend duration, and improve safety.

Participants in this course gain comprehensive knowledge and technical proficiency in performing IVRA using updated, evidence-based protocols. Instruction focuses on patient selection, dosing, procedural technique, and rapid recognition and treatment of complications. Clinicians learn to apply safety checklists, integrate adjuncts, and optimize outcomes through structured interprofessional collaboration. Anesthesia clinicians, surgeons, perioperative nurses, and emergency staff coordinate during preparation, monitoring, and recovery, ensuring efficiency and communication. Participants enhance patient safety, minimize complications, and deliver high-quality anesthesia care across diverse clinical environments by improving procedural skills and teamwork.


Target Audience

This activity has been designed to meet the educational needs of physicians, physician associates, nurses, pharmacists, and nurse practitioners.

Learning Objectives

At the conclusion of this activity, the learner will be better able to:

  • Identify patients who are candidates for Bier block (intravenous regional anesthesia), based on knowledge of the contraindications and the potential risks associated with the procedure.

  • Apply evidence-based knowledge and techniques for performing intravenous regional anesthesia, including forearm tourniquet placement, local anesthetic, and adjunct choice.

  • Identify signs and symptoms of intravenous regional anesthesia complications, such as tourniquet pain, local anesthetic systemic toxicity, and steps to manage them.

  • Implement effective interprofessional team strategies to develop a structured approach for providing adequate care to and appropriate surveillance of patients undergoing a Bier block.

Disclosures

StatPearls, LLC requires everyone who influences the content of an educational activity to disclose relevant financial relationships with ineligible companies that have occurred within the past 24 months. Ineligible companies are organizations whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or on patients. All relevant conflict(s) of interest have been mitigated. Hover over contributor names for financial disclosures. Others involved in planning this educational activity have no relevant financial relationships to disclose.

Commercial Support: This activity has received NO commercial support.

Continuing Education Accreditation Information

In support of improving patient care, StatPearls, LLC is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC) to provide continuing education for the healthcare team.

 

Physicians and Physician Associates: StatPearls, LLC designates this enduring material for a maximum of 1.00 AMA PRA Category 1 Credit(s)TM. Physicians and PAs should only claim credit commensurate with the extent of their participation in the activity.

American Board of Anesthesiology: This activity contributes to the CME component of the American Board of Anesthesiology’s redesigned Maintenance of Certification in AnesthesiologyTM (MOCA®) program, known as MOCA 2.0®. Please consult the ABA website, www.theABA.org, for a list of all MOCA 2.0 requirements.

American Board of Orthopaedic Surgery: Successful completion of this CME activity, which includes participation in the evaluation component, enables the learner to earn credit toward the CME and Self-Assessment Examination requirements of the American Board of Orthopaedic Surgery’s (ABOS) Maintenance of Certification program. It is the CME activity provider's responsibility to submit learner completion information to ACCME for the purpose of granting ABOS credit.

American Board of Pathology: Successful completion of this Continuing Certification activity, which includes participation in the evaluation component, enables the participant to earn up to 1.00 Lifelong Learning (CME) credits in the American Board of Pathology’s Continuing Certification Program.

American Board of Pediatrics: Successful completion of this CME activity, which includes participation in the evaluation component, enables the learner to earn up to 1.00 MOC points in the American Board of Pediatrics’ (ABP) Maintenance of Certification (MOC) program. It is the CME activity provider’s responsibility to submit learner completion information to ACCME for the purpose of granting ABP MOC credit.

American Board of Surgery: Successful completion of this CME activity, which includes participation in the evaluation component, enables the learner to earn credit toward the CME and Self-Assessment requirement(s) of the American Board of Surgery’s Continuous Certification program. It is the CME activity provider's responsibility to submit learner completion information to ACCME for the purpose of granting ABS credit.

Royal College of Physicians and Surgeons of Canada: Through an agreement between the Accreditation Council for Continuing Medical Education and the Royal College of Physicians and Surgeons of Canada, medical practitioners participating in the Royal College MOC Program may record completion of accredited activities registered under the ACCME’s “CME in Support of MOC” program in Section 3 of the Royal College’s MOC Program.

Please consult your professional licensing board for information on the applicability and acceptance of continuing education credit for this activity.

Method of Participation and Credit

  1. Register for the activity.    
  2. Review the target audience, learning objectives, and disclosure information.
  3. Study the educational content of the enduring material.
  4. Choose the best answer to each activity test question. To receive credit and a certificate, you must pass the test questions with a minimum score of 100%.
  5. Complete the post-activity assessment survey.

If you have concerns regarding the CE/CME system, please contact support@statpearls.com.

Disclaimer

This educational activity was planned and produced in accordance with the ACCME Standards for Integrity and Independence in Accredited Continuing Education. Faculty may discuss investigational products or off-label uses of products regulated by the FDA. Readers should verify all information before employing any therapies described in this educational activity.

The information provided for this activity is for continuing education purposes only and is not meant to substitute for the independent medical/clinical judgment of a healthcare provider relative to diagnostic and treatment options of a specific patient’s medical condition. The information presented does not necessarily reflect the views of StatPearls or any commercial supporters of educational activities on statpearls.com. StatPearls expressly disclaims responsibility for any adverse consequences resulting directly or indirectly from information in the course, for undetected error, or through a participant's misunderstanding of the content.

Unapproved Uses of Drugs/Devices: In accordance with FDA requirements, the audience is advised that information presented in this continuing education activity may contain references to unlabeled or unapproved uses of drugs or devices. Please refer to the FDA-approved package insert for each drug/device for full prescribing/utilization information.

Cancellation Policy: Please see the cancellation policy. StatPearls, LLC reserves the right to cancel any course due to unforeseen circumstances.

 

 
 

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Unlimited Physician CME

Stay up to date on the latest medical knowledge with 6279 CME activities. In these online self-assessment activities, read our reference articles and test your knowledge with more than 7486.5 hours of CME.

Learn About Lifetime CME

Single Activity

Take this single activity

$49 1 activity

6 Month Unlimited Physician CME

Access to all the Unlimited Physician CME activities in all specialties.

$399 per half year per user

1 Year Unlimited Physician CME

Access to all the Unlimited Physician CME activities in all specialties.

$649 per 1 year per user