Warning: “It’s too hard to inject!”
What about HIGH Injection Pressures? Accidental intraneural or intrafascicular injection, especially under high pressure (>15-20 psi), can lead to permanent nerve injury. Whenever we hear an experienced assistant say these words, they have our attention. At times, it is anticipated, such as when we have excellent needle tip visualization and we know that we are.. read more →
Nuances to Ultrasound-Guided Subgluteal Sciatic Nerve Block Part 1
Full Commentary on “Ultrasound-Guided Sciatic Nerve Block in Overweight and Obese Patients” by Abdallah et al, Regional Anesthesia & Pain Medicine Vol 38, Number 6, Nov-Dec 2013, p547-552 There are a number of points made in this article that I find very interesting and that I believe are worth discussing further. Some of.. read more →
Identifying the Subgluteal Sciatic Nerve
Let’s briefly go over how you should go about finding the sciatic nerve at the subgluteal position. First, patient positioning is important (so is yours, but ergonomics is a subject for another day). Having the patient pull their knee forward and flex at the hip will ‘tighten’ the tissue layers which will bring structures closer.. read more →
In Case of EMERGENCY, Do THIS!
One of my attendings at UT, Knoxville used to say, “If you earnestly worry about something, it won’t happen.” It was generally taken as a joke to some when it was said. It was like the ‘cure’ to a difficult arterial line insertion was having someone else open another pair of sterile gloves. It is just.. read more →
Evaluating your TAP Block Injection
Is This Where I’m Supposed To Be? TAP Blocks are EASY!! Well, they’re easy MOST of the time. There is the issue of the ‘not very solid’ structures to try to penetrate, and sometimes the target plane can be a significant distance from the surface. Oh yea, and don’t exert too much pressure with the.. read more →
Nursing Inservice Series: Safety and Risks
RN Inservice Series Safety and Risks from CPNB Consulting read more →