Special Operations Forces Medical Handbook

5-170

2. Prep area.


3. Rotate the leg medially to gain access to the lateral posterior aspect of the foot.


4. Inject 5 mls of local anesthetic solution on the lateral side of the foot between the Achilles tendon
   and the posterior lateral malleolus.

c. Deep Peroneal Nerve Block (Figure 5-40)

What To Do:

1. Assemble equipment.


2. Prep area.


3. On the dorsal surface of the foot, locate the dorsalis pedis artery and the extensor hallucis longus
   tendon (tendon to the great toe).


4. Insert the needle between the dorsalis pedis a. and the extensor hallucis longus. If a paresthesia of
   the great or second toe is obtained, inject 5 mls of local anesthetic solution.


5. If a paresthesia is not obtained, advance the needle until bone is contacted and inject the 5 mls of
   local anesthetic solution in a fan-like manner while withdrawing the needle.

d. Tibial Nerve Block (Figure 5-41)

What To Do:

1. Assemble equipment.


2. Prep area.


3. Rotate the leg laterally to gain access to the medial posterior aspect of the foot.

Sural Nerve Block

Fingers approximating

bony landmarks

Sausage shaped injection

between achilles tendon

and lateral malleolus

Figure 5-39