Outpatient Surgery Magazine

No Guarantees - March 2017 - 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/798078

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Page 113 of 138

electronic pumps complete their treatment, they can mail the pumps back to their providers. In either case, one of the big determining factors in which type you purchase is likely to be how much control you want your patients to have. Many providers and facilities set a certain infusion rate and liter- ally take away the key. They won't even let nurses, let alone patients, change the rates. But if you take that approach, you limit your ability to customize care for each particular patient. Does the pump have a bolus option? I prefer to use programmable pumps and allow patients the option to adjust infusion rates within certain parameters and also to give themselves boluses when they feel the need. In addition to helping with breakthrough pain, the bolus provides more spread in the tissue plane, so the pump can do a better job of saturating a larger area. That's really useful for any block where the catheter isn't right next to the nerve, such as an adductor canal or an infraclavicular block, where you have 3 cords of the brachial plexus bundled around the axillary artery. With elas- tomeric pumps, the extra push provided by the bolus may be a little slower and weaker, so it may not provide the same spread as their electronic alternatives. "Is it working?" Educating patients and their caregivers helps immensely. You'll be sending a patient home with a small plastic catheter coming out of their body. The more the patient knows about it and what it's doing, the better chance of limiting complications. Electronic pumps are a little more complicated with their various dials and alarms, so they require a more detailed tutorial. On the plus side, if there's an occlusion with an electronic pump, or for some rea- Thinking of Buying … TB 1 1 4 • O U T PA T I E N T S U R G E R Y M A G A Z I N E • M A R C H 2 0 1 7

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