Bier's Block at SJH

If a patient is suitable for a Bier's Block procedure, please book them onto the next available SJH ED Bier's Block clinic at SJH. Be mindful of overly delaying the procedure if this is over a long weekend.

DO NOT book more than one Bier's Block per day. If there are delays in starting a Bier's Block procedure, or the procedure take a longer time than intended, this may need for further procedures to be cancelled, especially as this non-emergent activity will be taking place at the same time as more urgent ED work. Despite this advice, and in extenuating circumstances, if you still wish to try to double book a procedure, you must discuss this with the consultant scheduled to perform the procedure.

If there are no timely clinic slots for Bier's Block at SJH, it might be possible to arrange this procedure at the RIE. Please see the following section on how to do this.

Due to the lack of available Bier's Block clinic slots at SJH, in April 2025 it was agreed between SJH ED and orthopaedics that these patients can be booked onto the next available RIE Bier’s Block list. If you are considering this be mindful of patient circumstances (e.g. if they can get to RIE easily), and also if the wait for the RIE clinic is longer than for the SJH clinic.

In cases where a patient will be booked onto the RIE Bier's Block list, you should follow the usual SJH pathway (e.g. discuss the case with the senior decision maker), and also follow the RIE protocols as listed on the RIE RDS section.

If you have a patient with a distal radius fracture that would be suitable for manipulation under Bier’s Block then please check if there is available list the following week-day in SJH and if not then please call RIE ED reception, extensions 21300 / 21301, and ask for the patient to be added to the next RIE Bier’s block list.

Please also print and complete the check-list and give this to the patient along with the RIE patient information leaflet to take to RIE when they attend for the procedure.