Discuss the procedure with the patient regarding desired effects and potential complications
They should be made aware that they will lose both sensory and motor function appropriate distribution until the anesthetic wears off
Perform a full motor, sensory, and vascular examination of the targeted area prior to anesthetic administration
Place the patient's extremity in a position allowing for easy access to the injection site
Cleanse the appropriate area of skin with chosen antiseptic
Create a sterile field using your sterile drape
Palpate the Medial Malleolus and Achille's Tendon
The appropriate site is approximately 1 cm superior to the Medial Malleolus and anterior to the Achille's Tendon
The injection site should be superior and posterior to the area that the Posterior Tibial pulse is felt
In a sterile fashion, apply a small wheel of local anesthetic to this area
Directing the needle from medial aspect towards lateral, advance the needle with negative pressure applied to the syringe
It is important to aspirate prior to injecting anesthetic to rule out Posterior Tibial Arterial placement
Discontinue and reposition should the patient report shooting "electrical" pains or numbness prior to injection
Inject approximately 5 mL of local anesthetic
This block will require anesthetic to be placed across the proximal aspect of the dorsum of the<unk>  from the Medial Malleolus to the Lateral Malleolus
In a sterile fashion, apply a small wheel of local anesthetic immediately anterior to the Lateral Malleolus
Directing the needle medially, advance the needle through the wheel of anesthetic and advance across the anterior aspect of the<unk>  applying negative pressure to the syringe until the medial aspect is reached
Discontinue and reposition should the patient report shooting "electrical" pains or numbness prior to injection
Assuming no blood was aspirated upon advancing the needle, inject approximately 10 mL of anesthetic as you slowly withdraw the needle
This block is similar to the Posterior Tibial Nerve block, albeit on the lateral aspect of the ankle
In a sterile fashion, place a wheel of local anesthetic between the Lateral Malleolus and Achille's Tendon
Directing the needle from lateral to medial direction, advance the needle with negative pressure applied to the syringe
Discontinue and reposition should the patient report shooting "electrical" pains or numbness prior to injection
Inject approximately 5 mL of local anesthetic to this area
Nerve Block: Foot
Nerve Block: Upper Extremity
Nerve Block: Ulnar Nerve
Nerve Block: Penile
Nerve Block: Radial Nerve
Nerve Block: Femoral
Nerve Block: Median
Nerve Block: Occipital