Regional Info Flashcards
What happens to nerve fascicles when using a short beveled needle?
They move away from the needle tip
Is the rate of bacterial colonization of peripheral nerve catheters high or low?
HIGH, but local inflammation/infection/abscess/sepsis are rare
Some risks of continuous nerve blocks?
delayed LAST, nerve injury, infxn, pulmonary issues with phrenic nerve block, catheter migration/knotting/retention
Where is the needle weakest?
at the hub
Can you pull the catheter back through the needle?
NO, risk of shearing/breaking
What should you do if the catheter breaks?
Xray to find out where it is. Tell the patient. Can be left in, unless it is in the subarachnoid space.
What are some benefits of using a nerve stimulator?
Decrease in volume/dose of LA, increased success rate, block nerves that are hard to locate
How does the nerve stimulator work?
It uses specialized shielded needles to locate the distribution of the stimulation charge to the tip of the needle. Improves the locating of neural fibers without eliciting paresthesias.
Which leads are which in the nerve stimulator?
NEGATIVE attached to SKIN. POSITIVE attached to needle
When do you turn on the nerve stimulator?
AFTER the needle has entered the skin
What do you do to the amplitude as the needle approaches the nerve??
DECREASE it to 0.5 mA when it enters the sheath. This ensures that muscle response is maintained, decreases pain to pt
What is the key condition for a successful regional block?
Confirmation of an appropriate volume of local anesthetic around the targeted nerve structures
What frequency probes are good for superficial structures?
Higher freq 10-13 MHz for things < 4 cm deep
What frequency probes are good for deep structures?
Lower freq 2-5 MHz
Hypoechoic
Dark. Nerve tissue. Does not reflect US waves. Little energy.n
