Outpatient Surgery Magazine

Is Your Data Secure? Subscribe to Outpatient Surgery Magazine - November 2017

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

Issue link: http://outpatientsurgery.uberflip.com/i/897409

Contents of this Issue

Navigation

Page 66 of 122

5. Multimodal pain protocols The ingredients and doses vary from provider to provider and from procedure to procedure, but the goal is the same: Attack the various ways pain is perceived in the spinal cord, the peripheral nerves, the central nervous system and the brain, and do so with an eye toward minimizing opioids and the issues that surround them. Regional anesthesia is a good starting point, and the long list of potential ingredients may include IV acetaminophen, bupivacaine, IV ibuprofen, IV diclofenac, epinephrine, clonidine, saline, steroids, NSAIDs, ketorolac, ketamine, celecoxib and gabapentinoids, among others. Anesthesia providers have become skilled mixologists, with many actively seeking feedback and data that can help them standardize their approaches. Avoiding the knee-jerk tendency to lean too heavily on opioids is the key. "All of these multimodal pain protocols can real- ly work," says Mr. deSouza. "But only if the support staff has the time to honestly implement them." 6. Ultrasound guidance "It's always amazing to me why people don't use ultrasound more," says Merlin Wehling, MD, director of anesthesia at the Kearney (Neb.) Regional Medical Center. "I've never seen a downside." He and others say it's indispensable once you get the hang of it. "You can use it any- where on anything in the body — not just for nerve blocks and pain injections. The only reason we don't use it more is the lack of machines available, but they're not terribly expensive." A little education goes a long way, says Dr. Wehling: "We recently instructed nurses to use ultrasound with peripheral IV starts. Their reaction was, Are we allowed to? Is that within the scope of practice? N O V E M B E R 2 0 1 7 • O U T PA T I E N T S U R G E R Y. N E T • 6 7

Articles in this issue

Archives of this issue

view archives of Outpatient Surgery Magazine - Is Your Data Secure? Subscribe to Outpatient Surgery Magazine - November 2017