Chua ISY, et al. - This study sought to assess the efficacy (length of stay in the emergency department and failure rate of Bier’s block) and safety profile (death and major complications) of Bier’s block in its use for manipulation and reduction of paediatric forearm fractures. In the appropriate population and fracture types, Bier’s block proved a safe technique for reduction of fractures with a low failure rate and no major complications including death. It had a shorter length of stay in the emergency department compared to the ketamine group. As per findings, this practice should be adopted for manipulation and reduction of pediatric forearm fractures in the emergency department with a formalised protocol to reduce and prevent any human errors that could potentially result in complications.