====== Calcium Bier Block Technique ======

  - Ensure patient attached to cardiac monitoring
  - Insert an IV catheter into dorsum of the affected hand.
  - Ensure IV catheter also in opposite hand
  - Elevate the limb and drain the superficial veins of the arm
  - Apply a double-cuffed pneumatic tourniquet above the elbow
  - Inflated cuff to 100 mm Hg above systolic blood pressure.
  - Infuse 10 to 15 mL of 10% calcium gluconate plus 30 mL normal saline (DO NOT use calcium chloride in view of its increased risk of tissue toxicity)
  - Maintain ischaemia for 25 minutes
  - Then sequentially release the cuff over 3 to 5 minutes.
  - Pain relief should be evident within 30 minutes of cuff release.