Pain Pump Balls

As a clinical requirement for my Adult 1: Medical-Surgical course, I had the opportunity to observe a patient in the Operating Room and in the Post Anesthesia Unit of Advocate Good Samaritan Hospital. The procedure that I observed was a left total knee replacement. The patient needed this surgery because she was experiencing osteoarthritis, and this surgery could alleviate her pain and discomfort. I was with the patient from the end of her stay in the pre-operative holding area to the Operating Room, and then to the Post Anesthesia Care Unit. This paper will include background inquiry, preoperative and operative

Anesthesiologists give patients anesthetics in a variety of ways, such as “orally, intravenously, by gas or direct injection to render patients insensible to pain Anesthesiologists typically maintain the same daily schedule a surgeon follows, participating in both scheduled and unscheduled operations. Anesthesiologists are responsible for determining the proper anesthetic and dosage level for each patient. They monitor the patients progress prior to, during, and after surgery.”(“Anesthesiologist” 31)

The work of Burke, et al (2011) reports that a study with the objective of comparing the "efficacy of intradermal bacteriostatic normal saline with that of intradermal buffered lidocaine in providing local anesthesia to adult patients prior to IV catheterization." (p.1) The study concluded that intradermal buffered lidocaine was superior to intradermal bacteriostatic normal saline in providing local anesthesia prior to IV catheterization in this group of predominately white adults and should be the solution of choice for venipuncture pretreatment." (Burke, et al, 2011, p.1) Burke et al reports that surgery is something that most people fear with the fear of the unknown is combined with "apprehension about such anticipated procedures as insertion of an IV line." (2011, p.1) Burke additionally reports that patients admitted for same-day surgery "require IV access. Any venipuncture, including peripheral IV catheterization with a medium-to-large-gauge catheter, can cause some degree of pain. Using local anesthesia prior to IV catheterization has

An informal survey of perioperative nurses, physicians and patients was performed regarding the use of thigh-length versus knee-length SCD’s. The surgical services management team, clinical nurse educator, surgeons, and materials management were also involved in the process of using only knee-length SCD’s on all surgical patients. The surgeons, staff, and patients were perceptive and willing to use only knee-length SCD’s. The perioperative nurses were hesitant at times to call the physician for an order to place knee-length SCD’s on the surgical patient. This was a barrier to the suggested change project.

The practice of patient-controlled analgesia (PCA) has been around for approximately four decades now. During this time there have been improvements to the technology and the understanding of how to use this form of patient pain control; however, there continues to be concern related to the safety and efficacy of PCA. As this analysis proceeds it will briefly explain what PCA is and how it is used, then delve into the benefits and the safety issues surrounding PCA use as it pertains to the patient and the nurse. Some of the benefits of PCA include improved pain management, improved use of nursing resources, increased patient satisfaction, and reduced pulmonary issues (Hicks, Sikirica, Nelson, Schein & Cousins, 2008). Some of the safety

Certified Registered Nurse Anesthetists (CRNAs) are one of the most advanced types of nurses. They are responsible for providing quality anesthesia and anesthesia-related care in order to facilitate diagnostic, therapeutic and surgical procedures (America Association of Nurse Anesthetists, 2010). While their services are mainly used in the surgical setting, CRNAs can also provide assistance for pain management associated with obstetrical labor and delivery or for chronic and acute pain. Although they typically work under the supervision of Anesthesiologists, based on states regulations and by laws, they may also work independently (Kansas University Medical Center, 2014).

She is with the patient throughout the full process. Before the operation, she will prepare the patient to receive the anesthesia and will perform a full patient assessment. This determines any patient allergies to certain chemicals or drugs; what medicine the patient can receive; how their bodies will react; and where the injection should be administered. Sometimes, the drug will be given in the form of an onsite injection, similar to an epidural. When the operation begins, Kelly will then assist the physician with monitoring and administering the anesthesia to ensure proper sedation. If the patient is not fully put to sleep, and a portion of his or her body is numbed instead, she monitors the input on the site of injection and ensures the patient cannot feel anything throughout their body. When the procedure is concluded, Mrs. Leonard’s duties will continue. She is in charge of overseeing that the patient recovers from the anesthesia smoothly and cares for the patient’s post-operative needs until they are

According to surveys, up to 80% of patients reported moderate to severe post-surgical pain, which can sometimes be left undertreated (Sinatra et al., 2005). Postoperative pain is generally managed with opioids, which carry numerous side effects. Side effects can be bothersome and possibly cause a delay in the postoperative healing process (Beard, Leslie, & Nemeth, 2011). IV acetaminophen can possibly decrease opioid consumption, minimize side effects, increase patient satisfaction, and decrease costs (Wininger et al., 2010). The purpose of this paper is to dive further into the research to present data on the effectiveness of IV acetaminophen in decreasing opioid usage and whether it produces an additive effect causing more effective pain management in the postop patient.

These may include multimodal analgesics, opioids, repositioning, and

Regardless of the number and type of practitioners involved, the MDA retains virtually all responsibility of the patients. The anesthetic management is delegated by the MDA to any of the team members that participate in this model. The CRNA’s role, in this model, would be to implement the concluded plan formulated through collaboration of the team.

A physician with a wealth of experience in the fields of anesthesiology and pain management, Dr. Daniel Kendall has served as an interventional pain medicine specialist with National Spine and Pain Centers for 17 years. He treats patients out of National Spine and Pain’s Arlington location near his home town of Vienna, Virginia. Before assuming his current position, Dr. Daniel Kendall served as chief fellow of pain management at Johns Hopkins Hospital in Baltimore, Maryland. His experience with Johns Hopkins included training in advanced modalities such as sympathetic blocks, vertebroplasty, intrathecal pumps, IDET, radiofrequency ablation, and spinal cord stimulation.

The management of postoperative pain has received much interest nowadays. The intensity of postoperative pain depends on many factors such as type and duration of the surgery, type of anesthesia and analgesia used, and the patient’s mental and emotional status (11).

Learning about the potential complications of epidural reinforced my knowledge in being able to choose the right anaesthetic monitoring equipment. Knowing that Spinal and epidural anaesthesia can cause unpredictable and profound arterial hypotension necessitate the use of adequate monitoring like the; Pulse oximetry, ECG and Blood pressure cuff. This knowledge will help me to be able to select appropriate monitoring devices during epidural catheter insertion. Also it goes without saying that an epidural must be performed in a work area that is equipped for airway management and resuscitation.

While working on a surgical GI unit, I was informed by my nurse that my patient was discharged and that I was going to be assigned to a new patient. My patient had an anastomotic leak from his previous surgery and there was a possible chance of sepsis. He had two Jpratt drains, an ileostomy, an NG tube and lastly some wound dressings. One of the aspects that was different from this patient and other patients, is that he had a patient controlled analgesia pump (PCA). “A PCA is an interactive method of pain management that permits patients to manage their pain by self-administering doses of analgesics, usually opioids” (San Diego Patient Safety Task Force, 2008). My patient had the PCA pump because of his increased pain due to the complication

Not all theories are perfect, they are constantly changing and evolving with time and research. A flaw of Kolcaba’s Theory of Comfort is that upon analyzing and assessing someone’s level of comfort, one would notice this is a very subjective finding. Certain surgeries are going to always be associated with the pain that follows. Some patients believe that their comfort level has not been reached by the nurse if they are still having pain, regardless of whether it is considered minimal or