an ultrasound guided olner nerve block can provide excellent anesthesia to the ner aspect of the hand and distal forearm either for its own sake for pain control or to facilitate other procedures to perform the procedure I'm going to use here the pal scanner on a nerve setting I often have to have the patient externally rotate and flex their arm so I can get access to theer nerve from the lateral side I'm going to put the scanner down in transverse orientation and the target to find is the artery once I've identified theer artery theer nerve iser of theer artery I can optimize my depth here and then follow those two structures up to a point where I feel reasonably confident that the artery has moved out of the way and I still have excellent access to the nerve to perform a block coming in from that erer aspect I'm going to put my needle in in longitudinal plane pop my donut of anesthesia around the nerve and within minutes the patient will start to have anesthesia of the allner aspect of the hand either to facilitate a reduction of a boxer's fracture or other procedures that I may do I will often combine this with another forearm block if needed particularly the median depending on the distribution of anesthesia that I need
