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F E B R U A R Y 2 0 1 4 | O U T P AT I E N T S U R G E R Y M A G A Z I N E O N L I N E
ANESTHESIA ALERT
chotic drugs, which ones should work normally and which we should
use with caution.
For example, results came back for a recent patient that indicated she
could have a reduced response to certain analgesics. If she didn't
respond as normal to a normal dose, a higher dose and frequent moni-
toring may have been needed to achieve the expected result. This infor-
mation is invaluable, especially if you don't know a patient very well.
Medicare, Medicaid and Tricare will cover the test, but private insurers
won't. When it's not covered, there's a sliding scale in which most
patients pay a couple hundred dollars. That's a small price to pay for
more effective and personalized care.
Count on C-arm fluoroscopy.
Use of the C-arm has become stan-
dard of care for injections, and we primarily rely on fluoroscopy
for needle visualization guidance. The use of fluoroscopy lets us pre-
cisely target the needle to treat specific pain generators. Visualization
guidance increases the accuracy and therefore speed and success of
the injection, which is better and safer for the patient. There are many
injections you cannot perform blindly, so the ability to utilize imaging
is essential.
Address radiation safety.
You may employ a trained and certified
radiation technician to run the fluoroscopy, but this doesn't dimin-
ish the importance of teaching radiation safety to your staff. Provide
radiation training to new staff members, and make sure they understand
what they need to do to decrease radiation exposure, including standing
back from the C-arm during injections, always wearing lead aprons or
standing behind a rolling lead shield, and making sure never to reach in
to help a patient while the fluoroscopy is in use. We use the C-arm's low-
dose setting whenever possible to limit exposure.
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