Outpatient Surgery Magazine

What Surgeons Want - November 2016 - Subscribe to Outpatient Surgery Magazine

Outpatient Surgery Magazine, providing current information on Surgical Services, Surgical Facility Administration, Outpatient Surgery News and Trends, OR Excellence and more.

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1. Have a dedicated block team If you're starting a regional anesthesia program, begin by hiring and training the very best staff. There's nothing wrong with the "everyone does everything" mentality of ambulatory surgery centers, but when it comes to a perineural catheter team, everyone should be specialized. I recommend a dedicated block team and block nurse to help with placing catheters. A one-to-one ratio of a block nurse to an anesthesia provider tends to work best. Our block nurse helps with setting up catheter trays, leading time-outs, educating patients, preparing local anesthetics, completing documentation and assisting with block placement. While everyone on the team should be trained in placing CNBs, not everyone needs to be an expert. Aim to have at least one senior mem- ber on every block team. In our 8-OR facility, there's at least one expert per block team who acts as part-clinician, part-educator when the patient is receiving the block. Your anesthesia staff can stay up-to-date about placing blocks by attending lectures, visiting other facilities to watch experts, using online resources like nysora.com, usra.ca and ultrasoundblock.com, and seizing every opportunity they can to practice catheter placement. 2. Take advantage of ultrasound I'm a firm believer that anesthesia providers should use ultrasound for every catheter placement. Not only does it make the procedure more efficient, but we're also starting to see data that show that there are safety benefits as well, such as decreased incidence of vascular punc- ture and decreased risk of systemic toxicity. It's also a big draw for your facility. Many anesthesia providers, especially younger ones, expect ultrasound to be available for block placement. This doesn't mean that you need to run out and purchase a $100,000 machine. The N O V E M B E R 2 0 1 6 • O U T PA T I E N TS U R G E R Y. N E T • 6 3

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