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tact patients each day they have pain pumps at home. "It's not very labor inten-
sive, and it's worth it to us because we get a lot of repeat patients who say they
appreciated that constant support," says Dr. Fingerman.
Also, give patients a number they can call to always reach someone at your
facility who can respond to questions or help them manage issues that might
arise. Dr. Fingerman's facility has a cell phone that members of the anesthesia
team share, so they can take turns answering calls made by concerned patients.
3. Tap into new technology
Newer ultrasound units are more affordable and a worthwhile investment, even
for smaller facilities. Zeroing in on the type of probes needed to place the blocks
your anesthesia providers use most often will help you save money on a new pur-
chase, according to Dr. Fingerman. "For most peripheral nerve blocks, you need
only one high-frequency probe," he says. "Low-frequency probes, meanwhile, are
useful for obese patients or for placing blocks deeper than 5 cm."
Another innovation to consider is catheter-over-needle technology, which can
make placing continuous blocks easier. Dr. Fingerman notes that skilled
providers can use the technique to place a block in just over 3 minutes.
Dr. Elkassabany says the catheter-over-needle technology seems to reduce the
risk of leakage and its echogenic qualities make it easy to see the catheter on
the ultrasound screen. And while previous editions of the technology weren't
easy to work with, newer versions aren't as "technically challenging," says Dr.
Fingerman.
Pain pumps have also come a long way, from simple, single-flow-rate devices
to high-tech models that feature patient controlled boluses, adjustable infusion
rates, 24-hour start delays, Wi-Fi connectivity and much more.
Though Dr. Elkassabany believes some of the new "smart" pumps can be
helpful, he suggests you find models that offer features patients find helpful, but
not overwhelming. "My concern is that newer pumps can become a burden," he
says. "If they're constantly sounding alarms or are hard to use, that becomes
