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annoying or confusing to the patient and will generate phone calls to the
provider."
4. Learn to troubleshoot
Dr. Elkassabany says providers may place a block and send the patient
home, only to receive a call hours later from the patient complaining of
severe pain. Part of the issue surrounds the catheters, which connect to the
pain pumps and often "have a mind of their own" by shifting after they've
been placed, says Dr. Elkassabany. To avoid this problem, train a nurse to
hold the ultrasound probe while the anesthesia provider uses the imaging to
help guide placement of the catheter.
Providers should also get into the habit of double-checking their work, sug-
gests Dr. Elkassabany. "Before you tape the catheter in place, inject solution
through it and use the ultrasound probe to watch where the solution is distrib-
uted and confirm that it's reaching the correct area," he says.
5. Ease into it
Dr. Fingerman says the best way to launch a continuous nerve block program is
to start small. Though they have a robust regional program in place at his facili-
ty, where providers place 15 to 20 continuous nerve blocks per week, it began
much smaller. "Start with one surgeon, one day a week, and send patients home
with one type of pain pump," he says. "Over time, surgeons will rubberneck and
see how well the blocks are working and say, 'Hey I want that for my patients.'
That's how you develop buy-in and grow the program."
OSM
