Welcome to Acute Pain/Regional Anesthesia!

Department Chief: Dr. Merman

Attendings: Dr. Mohapatra, Dr. Hopcian, Dr. Ghaly, Dr. Chamu

Coordinator: Denise Prybor (Denise.Prybor@UHhospitals.org)

Location: Seidman PACU in 2nd floor behind the Mather PACU.

Hours: usually 0545 to 1400, but not always.

On the first day of the rotation: Intern and Junior should text the senior the night before regarding logistics of the rotation and meeting time. Usually meets in the Seidman PACU by 0530-0545 AM. 

Attire: OR scrubs.

Since the transition to EPIC, many of our documentation and workflow items have changed.

Please review this presentation here before your first day for how to appropriately document blocks

 
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Acute Pain Junior Goals & Objectives <Download>

Acute Pain Senior Goals & Objectives <Download>

The Ultimate Resident Guide - Acute Pain Section

Expectations

Intern

  • Stocking ultrasound tower and the block cart daily

  • Assist in notes, blocks, and other procedures

  • Position descriptions:

    • Consents

    • Start IVs - always talk to your seniors before

    • Preps block kits 

    • Home Call 2 weekends

Junior

  • Responsible for obtaining all required medications from the omnicell

  • Responsible for performing most of the blocks and procedures

    • Home Call 1 weekend

Senior

  • Responsible for coordinating the team for smooth flow of the day

  • Assist the Junior for blocks

  • Perform advanced block procedures

    • Round with attending at least first two weeks

    • Home Call 1 weekend

Helpful Hints/Tips

      • Surgeons will often ask for blocks to be done postop (neurochecks, avoid delay of case start)

        • All postop blocks must be consented prior to surgery because patient cannot consent after anesthesia 

          • Rare cases warrant calling POAs to get consent if they weren’t consented preop for a postop block 

      • Do everything in your power to be efficient so you can leave at 1400- there should be no down time unless there is truly nothing to do

        • Call preop secretary to make sure patients are brought to preop area when they arrive in waiting 

        • Call surgical teams to get consent 

        • Divide and conquer tasks 

      • May get consulted for something that is more appropriate for chronic pain- refer the service to the appropriate consult pager 

      • PRACTICE! You won’t get better at finding your needle if you don’t do blocks and practice on the phantom - ask senior/ attending about the phantom (even then, sometimes you won’t see your needle)

 

Educational Resources

NYSORA

Available Dot Phrases on iPad

Adductor canal (“adductor”)

Axillary (“axillary”)

ESP (Erector spinae plane) (“esp”)

Infraclavicular (“infraclavicular”)

Interscalene (“interscalene”)

Popliteal (“popliteal”)

QL catheters (“qlc”)

QL single shot (“qlss”)

Supraclavicular (“supraclavicular”)

How to add more dot phrases

Go to Settings > General > Keyboard > Text Replacement
Add new dot phrases by pressing “+” > type in the phrase and the shortcut > “save”