What happens if you have a patient who steps on a nail? How can you make this procedure easier for you and the patient? 

– Use a Posterior Tibial Nerve Block! !

To Perform This Procedure:

• Have the patient lay on a stretcher and externally rotate their hip and have their knee flexed.
• Clean the area  
• Use a linear probe with a sterile probe cover on
• Place the probe with the marker towards the patient’s right, just above the medial malleolus and positioned posteriorly.
• Identify the posterior tibial nerve next to the posterior tibial artery and center the probe on the nerve
• Use a 22–30-gauge needle in an out of plane technique, slowly inject about 5 cc of anesthetic, making sure you are just above the nerve and not in the artery.

References

https://www.acep.org/patient-care/map/map-posterior-tibial-nerve-block-tool

Tibial — Highland EM Ultrasound Fueled pain management (highlandultrasound.com)