Implementing targeted scalp nerve blocks in urgent care: a practical innovation for head and scalp laceration management

Head and scalp lacerations are common in emergency and urgent care settings, where local infiltration anesthesia, although effective, can distort tissue planes, obscure landmarks, and increase patient discomfort, particularly in pediatric and elderly populations. In contrast, neurosurgical practice routinely employs regional scalp nerve blocks for awake craniotomies, providing reliable anesthesia without tissue disruption. Despite strong evidence supporting their safety and efficacy, these blocks remain underutilized in urgent care, largely due to limited familiarity with scalp sensory anatomy and uncertainty regarding injection landmarks. We hypothesized that clear, clinically oriented illustrations derived from existing literature would improve understanding of scalp nerve blocks and support broader adoption in non-surgical settings. A comprehensive literature review was conducted focusing on scalp nerve anatomy, injection techniques, anesthetic agents, safety profiles, and clinical indications. Based on these findings, original, landmark-based anatomical illustrations were developed to depict major sensory nerve distributions and corresponding injection sites in a simplified, practical format for clinicians without specialized procedural training. Published studies consistently demonstrate that regional scalp nerve blocks provide effective anesthesia with minimal tissue distortion, reduced anesthetic volume, and improved patient comfort compared with local infiltration; however, existing resources lack consolidated, user-friendly visuals tailored to urgent care providers. The illustrations created in this project map key nerve pathways and targeted injection sites, demonstrating how common laceration patterns can be anesthetized with one or two strategically placed blocks. Regional scalp nerve blocks represent a safe, efficient, and underutilized alternative to infiltration anesthesia, and integrating clear anatomical visuals with current evidence may enhance clinician familiarity, procedural confidence, patient comfort, and efficiency in outpatient wound repair.