Outpatient Surgery Magazine

Unsung Heroes - November 2019 - 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.

Issue link: http://outpatientsurgery.uberflip.com/i/1183510

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Page 97 of 146

in these individuals, according to Roman Margulis, MD, an assistant site director at Montefiore Health's Joint Replacement Center in the Bronx, N.Y. "CNBs also work well for patients with respiratory issues, and other worrisome comorbidities such as high BMIs and pulmonary issues — indications the patient won't tolerate opioids well," he says. Clinical upgrades Continuous catheter designs have progressed over the years, making them more appropriate to send home with patients. While some physi- cians once had concerns about using the systems due to potential kinking, leaking, clogging or pump failure, the delivery systems today are made of more resilient materials that are not as prone to those issues as they were in the past. • Better pumps. Elastomeric pumps are simple devices that are easy for patients to use. Some models feature patient-controlled medication boluses for managing breakthrough pain. More advanced electronic pumps provide better control of medication delivery rates and have the ability to automatically administer pre-programmed intermittent boluses. Some pumps can also be programmed to give the patients the ability to self-administer boluses within pre-set parameters. "While an elastomeric pump delivers a consistent, moderate amount of analgesia, some experts believe electronic pumps offer better, more controlled pain control because the medicine fills the incision space when you want it to instead of continuously run- ning at a higher volume," says Emily Winchester, RN, a block nurse at the San Francisco (Calif.) Surgery Center. Electronic pumps have integrated sensors that detect if medication delivery is interrupted and alarms that alert the patient to the mal- 9 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 9

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