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/291534
4 2 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 | A P R I L 2 0 1 4 • Ultrasound machine. Purchasing the correct machine will depend on your resources and the type of blocks you perform. Ultrasound machines range from $5,000 for refurbished models to more than $100,000 for 3D models. Most important is that you choose the equipment that can accomplish the blocks you plan on performing. Picture quality is essential in the success and safety of your blocks. Multiple probe options are available for most machines and understand- ing their use is essential. For example, a higher frequency probe will give you a much better quality image but tissue penetration depth will be limited often to 2 to 4cm. On the other hand, a lower frequency probe will give you much better tissue penetration but limit your image quality. Before you purchase your machine, consider the portability of the device, image storage and transfer, Doppler and color flow options are all considerations. • Nerve block cart. Your block cart should be spacious and portable. Carts should have a locking mechanism and be well-marked. Stock a wide variety of local anesthetics, block needles, syringes, Chloraprep, continuous and single-shot trays, catheters and gloves. Designate one drawer for emergency equipment if the cart is to be portable and used away from the primary anesthetizing location. This should include the intralipid rescue kit. Portable carts should also include emergency medications: epinephrine, atropine, ephedrine, phenylephrine, midazolam, succinylcholine, propofol or barbiturates. • Nerve block needles. A wide variety of nerve block needles is available. Needles are designed based on their length, gauge, echogenicity, bevel and insulation qualities. Many of the new needles focus on the ability to enhance their visualization with the use of ultrasound; etching on the outer diameter of the needle enhances their echogenicity. Echogenicity is the ability to reflect the ultrasound waves back to the transducer, enhancing visibility. R E G I O N A L A N E S T H E S I A OSE_1404_part2_Layout 1 4/4/14 2:38 PM Page 42