ties that place CNBs is that if a patient ever
has a problem — and there will be prob-
lems, even in our program where we're placing dozens of blocks a
week — we don't shy away from bringing the patient back in and fix-
ing it.
Part of placing continuous nerve blocks is understanding that there
are inherent risks associated with the procedure and that the success
rate is not 100%. But what's more important is how you handle these
issues. For example, if a catheter comes loose or migrates, impacting
the patient's comfort, we don't simply tell the patient, "Sorry, take
your pain medications. There is nothing we can do," as some facilities
may do. Rather, we bring them back in and will either replace the
block or adjust the catheter until they're no longer in pain.
For facilities interested in adding CNBs to their program, I highly
recommend that you not only have a plan in place for patients pre-
senting with emergency complications (which are exquisitely rare),
but also for the more minor issues like the ones above that may be an
inconvenience for the patient. Not only could you help reduce the risk
of hospital readmissions for pain or catheter problems, but patients
will also take notice of the extra effort you put into their care.
OSM
6 8 • O U T PA T I E N T S U R G E R Y M A G A Z I N E • N O V E M B E R 2 0 1 6
"To see the needle better,
insert the needle much farther
from the ultrasound probe."
Dr. Winchester (brandon@blockjocks.com) is the regional anesthesia fellowship
director at Andrews Institute for Orthopaedics & Sports Medicine and co-founder
of blockjocks.com.