News

The Perfect Gift for a CRNA or Anesthesiologist

We all have certain friends or family members who are difficult to buy gifts for, regardless of the occasion. You’re not sure about their individual tastes or preferences, they already seem to have everything, or you’re simply indecisive when picking out gifts. Whatever the case may be, don’t worry; it happens to us all!

But for that special CRNA, anesthesiologist, or medical student in your life, an annual Block Buddy Pro subscription is a perfect gift for a birthday, graduation, or Christmas celebration. Instead of giving a gift that they may not like or will sell or return, give them the ultimate mobile resource to learn about the anesthesia nerve blocks that they’re studying and administering, so they have the most up-to-date knowledge from the classroom to the operating room. And if you’re not yet convinced, take a look at the benefits of a Block Buddy Pro subscription:

Stay Sharp

The gift of a Block Buddy Pro subscription will empower a student, CRNA, and anesthesiologist to learn new skills with stunning illustrations and videos. They will impress professors, patients, and professionals with the latest anesthesia knowledge. They can brush up on familiar techniques so they’re always ready to operate.

Unlimited Answers

Tap into Block Buddy Pro’s extensive collection of knowledge from highly-respected anesthesia experts. Our app is constantly updated with new information and improved techniques, so you’re always in the know. The Block Buddy Support Team is always on standby to answer any technical questions you may have. And if that’s not enough, our instructors are even available to answer medical questions and give advice. It’s like having access to the ultimate answer key at your fingertips!

Anytime, Anywhere

Block Buddy Pro is always there for you. Access Block Buddy Pro on mobile, tablet, and desktop, wherever and whenever you’d like. Review Lessons offline by downloading them directly to your phone. Block Buddy Pro is available in both the Apple App Store or Google Play Store.

Ultimate Usability

No more flipping through pages and scanning chapters; just search for the information you need in Block Buddy Pro. Simple pinch-zoom and swipe navigation makes learning easier than ever. Lessons organized by Head/Neck, Upper Extremity, Truncal, and Lower Extremity sections for quick accessibility.

Peace of Mind

Reference the app to show a nervous patient exactly what you’ll be doing in their procedure. Access your Notes easily from each individual Lesson to leave yourself tips and reminders.

How to Purchase

To purchase the gift of a Block Buddy subscription for a CRNA, anesthesiologist, or medical student, first visit the Block Buddy Pro registration page. Choose your Subscription, then click Add to Cart. Proceed to Checkout, then Create an Account for them. They will use this login information to access the app once they’ve downloaded it from the Apple App Store or Google Play Store. Remember that the subscription will auto-renew on a monthly or annual basis.

Enjoy giving the priceless gift of education to the special anesthesia provider in your life!

America’s Worst Drug Epidemic in History: The Opioid Crisis

We are in the middle of one of the deadliest epidemics in American history. Deaths from opioid overdose have quadrupled since 1999, with six out of ten overdose deaths in the U.S. involving an opioid drug. More than 1,000 patients are treated in emergency rooms daily for misuse of prescription opioids, and more than 500,000 people died from drug overdoses between 2000 and 2015.

Death rates from opioids now rival those of AIDS during the 1990s, far more than any other drug, yet opioid prescriptions have risen so sharply that in 2012, enough opioids were prescribed to supply every U.S. adult with his or her own bottle, according to the CDC. It has gotten so out of control that twelve states now have more opioid prescriptions than people. So with the opioid crisis finally coming to a head, medical professionals and pain management specialists are increasingly looking for alternative ways to control chronic pain.

Non-Opioid Alternative Treatment for Chronic Pain

The way we reduce opioid prescriptions is by finding alternative options for pain management that don’t have the dangerous side effects of opioids. Individuals who consume opiates over an extended period of time can develop a tolerance, requiring them to take more of these painkillers to elicit the same effect. This process can lead to addiction and increase the risk of overdose and death. Dr. LaPietra from St. Joseph’s Emergency Department in New Jersey helped launch the ALTOSM (ALTernatives to Opioids) Program in January 2016, which found ultrasound-guided nerve blocks as a safe alternative to opioids. “Hip fracture pain is exquisite,” says Dr. LaPietra, “(Patients) are in a lot of discomfort. They cannot move; they cannot breathe well. And within 5-10 minutes of the (ultrasound-guided) nerve block, she had complete pain relief.”

Non-Opioid Alternative Benefits of Ultrasound-Guided Nerve Blocks

Regional nerve blocks provide a better alternative for pain relief than opioids because they work locally. An anesthesia provider injects a local anesthetic and/or steroid around a specific nerve, group of nerves, or within a fascial place to reduce pain and inflammation. “What we are looking for is multimodal anesthesia,” said Yili Huang, DO, director of Northwell Health’s Pain Management Center. The modality is appropriate for any condition that involves nerve pain such as arthritis, sciatica, and chronic knee or back pain. “We want to balance our patients’ need for pain relief while limiting opioid use,” says Dr. Huang. “Nerve blocks give us a powerful non-opioid alternative.”

Additional Non-Opioid Benefits of Regional Nerve Blocks

Injuries that cause chronic nerve pain often require physical therapy, but many patients have too much pain to do P.T. An ultrasound-guided regional nerve block provides enough relief to allow patients to pursue physical therapy and regain strength. Not only that, but patients cannot develop a tolerance to nerve blocks, which provides a safe pain relief alternative for patients who have struggled with substance abuse and need to avoid taking addictive painkillers. All of these benefits are why more and more physicians are turning to ultrasound-guided nerve blocks instead of opioids. “I want to get the most bang for my buck,” said Dr. Huang. “The most pain relief for my patients from the least amount of medication. My job is to give them the relief they need to recover.”

Additional Resources: For more information about ultrasound-guided regional nerve blocks, visit GoOpioidFree.com and download the Block Buddy Pro app.

Block Buddy co-owner Scott Urigel was honored with the 2019 Alice Magaw Outstanding Clinical Anesthesia Practitioner Award. “It was an honor and privilege to be the recipient of this award.” Scott Urigel said. “Educating anesthesia providers and students through conferences, clinical rotations, and the Block Buddy Pro application has afforded me the opportunity to positively impact patient care and outcomes.”

The Alice Magaw Outstanding Clinical Anesthesia Practitioner Award was established in 1986 to recognize accomplishments of certified registered nurse anesthetists (CRNAs) who are involved in direct patient care. The recipient of the award is honored as a person who has made an important contribution to the advancement of nurse anesthesia practice.

A CRNA for nearly 20 years, Scott Urigel’s innovative style of clinical practice has led him to become an anesthesia business owner who employs both CRNAs and anesthesiologists. Through his business, he developed the Block Buddy Pro app and hosts educational conferences throughout the country, providing classroom and hands-on instruction for ultrasound-guided regional anesthesia nationwide.

Block Buddy Pro

Block Buddy Pro is an interactive app focused on providing ultrasound-guided peripheral nerve block and Point of Care Ultrasound education to anesthesia providers. The app offers lessons, videos, and a non-opioid medication guide to help anesthesia providers keep their skills sharp and provide the best care possible for their patients.

About the American Association of Nurse Anesthetists

The American Association of Nurse Anesthetists (AANA) was founded in 1931 in Park Ridge, Illinois. It is a professional organization representing nearly 53,000 CRNAs and student registered nurse anesthetists across the United States. As advanced practice registered nurses and anesthesia specialists, CRNAs administer approximately 45 million anesthetics to patients in the United States each year and are the primary providers of anesthesia care in rural America.

The owners and creators of Block Buddy, Scott Urigel and Jeff Molter, are elated to announce the launch of the new version of their regional anesthesia education mobile app – Block Buddy Pro.

Block Buddy Pro is an interactive anesthesia app focused on providing ultrasound-guided peripheral nerve block and Point of Care Ultrasound (POCUS) education to medical providers. The app offers detailed lessons, educational videos, intricate illustrations, a non-opioid Rx guide, and additional resources to help medical providers keep their anesthesia skills sharp and provide the best care possible to their patients. New app features include:

OFFLINE MODE
Download lessons to access information anytime, anywhere on mobile, desktop, or tablet.

LESSONS
Read detailed descriptions for ultrasound-guided peripheral nerve blocks and Point of Care Ultrasound (POCUS) with custom illustrations for visual learners.

VIDEO LIBRARY
Watch or listen to step-by-step demonstrations with exclusive footage from the operating room.

Rx GUIDE
Easily search and compare non-opioid analgesics to find the most effective medication for your patient.

Block Buddy Pro can be used on all devices (mobile, tablet and desktop) and can now be purchased in the Apple App Store or Google Play Store. A 1-year subscription is $99, or a monthly subscription can be purchased for $9.99 per month. To learn more about the ultimate anesthesia app, click here.

FAQ: Why Upgrade to the new Block Buddy Pro app?

About the Owners

Scott Urigel and Jeff Molter are highly skilled and respected anesthesia providers. Together they are co-owners of Western Reserve Anesthesia Education/Block Buddy, which provide both the Block Buddy Pro app and educational conferences for anesthesia providers and students. Both Scott and Jeff have received numerous awards and accolades for their service over the years. Most recently, Jeff received the 2019 Ohio CRNA of the Year Award in April. Scott was recently notified that he will be honored with the Alice Magaw Outstanding Clinician Award at the national meeting of the American Association of Nurse Anesthetists (AANA) in August 2019. To read full bios for Scott and Jeff, click here.

Press Release: The Society for Healthcare Epidemiology of America, December 2018.

Arlington, Va. — The Society for Healthcare Epidemiology of America has issued new expert guidance on how hospitals and healthcare providers may reduce infections associated with anesthesiology procedures and equipment in the operating room. The guidance, published in SHEA’s journal, Infection Control & Healthcare Epidemiology, recommends steps to improve infection prevention through increased hand hygiene, environmental disinfection, and continuous improvement plans.

“Even though the demands on anesthesia providers make infection prevention best practices more challenging, there are opportunities for improvement,” said Silvia Munoz-Price, MD, PhD, lead author of the guidance and Professor of Medicine at Froedtert & Medical College of Wisconsin. “We describe how the anesthesiology team and hospital leaders can optimize infection prevention in operating room anesthesia, and we give suggestions for the future, including the need for better equipment design.”

A growing body of research has shown that contamination in anesthesiology work areas is connected to healthcare-associated infections that put patients at risk. A survey of 49 U.S. and international facilities showed infection control policies and practices are inconsistent. A writing panel—consisting of representatives from SHEA, the American Association of Nurse Anesthetists (AANA), the Anesthesia Patient Safety Foundation (APSF), and the American Society of Anesthesiologists (ASA)—developed the guidance to establish procedures and best practices specific to anesthesia in the operating room

“Following these evidence-based guidelines will assist in reducing contamination in operating room anesthesia,” said Marjorie Geisz-Everson, PhD, CRNA, APRN, FNAP. “Collaboration between the anesthesia and infection prevention communities has resulted in a comprehensive model that includes best practices in lowering infections for hospital leaders and providers to implement. In addition, assessing current infection prevention practices will aid in decreasing infections that occur during procedures and equipment used in the operating room.”

The key recommendations include:

• Hand hygiene should be performed, at a minimum, before aseptic tasks, after removing gloves, when hands are soiled, before touching the anesthesia cart, and upon room entry and exit. The authors also suggest strategic placement of alcohol-based hand sanitizer dispensers.
• During airway management, the authors suggest the use of double gloves so one layer can be removed when contamination is likely and the procedure moves too quickly to perform hand hygiene. The report also recommends high-level disinfection of reusable laryngoscope handles or adoption of single-use laryngoscopes.
• For environmental disinfection, the guidance recommends disinfecting high-touch surfaces on the anesthesia machines, as well as keyboards, monitors and other items in work areas in between surgeries, while also exploring the use of disposable covers and re-engineering of the work surfaces to facilitate quick decontamination in what is often a short window of time.
• IV drug injection recommendations include using syringes and vials for only one patient; and that injection ports and vial stoppers should only be accessed after disinfection.
  The authors suggest that implementation of the recommendations requires multi-level collaboration within the hospital, regular monitoring, and evaluation of infection prevention practices with regular feedback for providers as well as clarity in expectations about behaviors. According to the guidance, leadership should define goals, remove barriers to infection prevention, and empower practitioners to meet standards.

The guidance was endorsed by the SHEA Board of Trustees, AANA, the Association for periOperative Registered Nurses (AORN), APSF, and the American Academy of Anesthesiologist Assistants (AAAA), with a letter of support from ASA.

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Silvia Munoz-Price, Andrew Bowdle, B. Lynn Johnston, Gonzalo M. Bearman, Bernard C. Camins, E. Patchen Dellinger, Marjorie A. Geisz-Everson, Galit Holzmann-Pazgal, Rekha Murthy, David Pegues, Richard C. Prielipp, Zachary A. Rubin, Joshua Schaffzin, Deborah Yokoe, David J. Birnbach. “SHEA Expert Guidance: Infection Prevention in the Operating Room Anesthesia Work Area.”

About ICHE
Published through a partnership between the Society for Healthcare Epidemiology of America and Cambridge University Press, Infection Control & Hospital Epidemiology provides original, peer reviewed scientific articles for anyone involved with an infection control or epidemiology program in a hospital or healthcare facility. ICHE is ranked 19th out of 83 Infectious Disease Journals in the latest Web of Knowledge Journal Citation Reports from Thomson Reuters.

Society for Healthcare Epidemiology of America (SHEA) is a professional society representing more than 3,000 physicians and other healthcare professionals around the world who possess expertise and passion for healthcare epidemiology, infection prevention, and antimicrobial stewardship. The society’s work improves public health by establishing infection-prevention measures and supporting antibiotic stewardship among healthcare providers, hospitals, and health systems. This is accomplished by leading research studies, translating research into clinical practice, developing evidence-based policies, optimizing antibiotic stewardship, and advancing the field of healthcare epidemiology. SHEA and its members strive to improve patient outcomes and create a safer, healthier future for all. Visit SHEA online at www.shea-online.org

In the past two years, there has been a vast increase in documented cases of misuse of prescription drugs. While stimulants used to treat attention-deficit hyperactivity disorder (ADHD) and central nervous system (CNS) depressants used to treat anxiety continue to be abused, nothing compares to the misuse of opioids, which is leading to a nationwide epidemic. According to the Department of Health and Human Services, opioid overdoses accounted for more than 42,000 deaths in 2016.

While prescription opioids are used to treat moderate to severe pain in both surgical and non-surgical patients, these medications are abused for various non-medical reasons. These include: relieving tension, curiosity/experimentation, getting “high”, countering the effects of other drugs, and help with sleep. Individuals who consume opiates over an extended period of time can develop a tolerance, requiring them to take more of these drugs to elicit the same effect. This can lead to addiction and increase the risk of overdose and death.

Hospitals and healthcare providers are now taking a new approach to tackle opioid abuse. Fewer opioid medications are being prescribed, in favor of other non opioid medications, such as Tylenol, Motrin and gabapentin. Patients undergoing surgical procedures are now being prepared for realistic expectations of post surgical pain. Some institutions are even taking a multidisciplinary approach to combating prescription opioids, encompassing the assistance of psychologists to help patients deal with the impact of pain. Learning how to safely dispose of opioids and pain medication is also important.

As Certified Registered Nurse Anesthetists and Anesthesiologists, what can we do to stop this increasing epidemic of opioid abuse? Some options include non-opioid medications, ultrasound-guided peripheral nerve blocks, and patient education. It’s also important for us to stay educated on new procedures and trends that can improve the lives of our patients, now and in the future.

Enhanced Recovery After Surgery: A Path to Avoid Opioids

In an opioid-driven world, what are other options to help patients after surgery and spare them from touching opioids? Enhanced Recovery After Surgery (ERAS) is one method. ERAS utilizes non-opioid medications and techniques to control pain, shorten recovery period or length of stay in a hospital, and decrease complication rates after surgery. Here’s what you need to know about Enhanced Recovery After Surgery (ERAS).

What is ERAS?

ERAS is a patient-centered, evidence-based, pain management strategy employed by CRNAs anesthesia providers to avoid the need for opioids and improve patient outcomes. ERAS uses robust patient communication and opioid-sparing techniques such as regional anesthesia, peripheral nerve blocks, non-pharmacologic approaches, and non-opioid medications. While a traditional pain management pathway includes patient assessment followed by opioid/non-opioid prescribing and discharge, ERAS follows a much more effective path.

ERAS Pain Management Pathway

1. Preadmission – patient/family education; recovery and pain management planning
2. Preoperative – minimize fasting to reduce anxiety and pain perception and improve diet recovery
3. Intraoperative – administer analgesics and nerve blocks for pain and nausea/vomiting management
4. Postoperative – patient assessment, plan medication, and multimodal medication prescribing
5. Post-Discharge – education on anesthesia recovery, surgical procedure, and pain management
6. Continued Quality Improvement – analysis of compliance and outcomes to improve care

The Advantages of ERAS

Research has consistently shown that adoption of enhanced recovery (ER) leads to significant improvements in patient satisfaction, outcomes, and reduction in cost of care. To successfully integrate ER into practice, a structured, collaborative, multidisciplinary approach accompanied by education and awareness campaigns can be valuable. According to the Future of Anesthesia Care Today, ERAS improves the following outcomes:

• ERAS provides an average savings of $880 to $5,560 per patient.
• ERAS reduces patient length of stay by 3-4 days on average.
• ERAS reduces 30-day patient readmission rates and costs.
• ERAS helps patients return to normal activities more quickly.

To learn more about Enhanced Recovery After Surgery (ERAS), please contact us.

Sources:
AANA – Enhanced Recovery after Surgery
JAMA Network – Enhanced Recovery After Surgery
Future of Anesthesia Care Today

Related Materials:

How to Safely Dispose of Opioids and Pain Medication

Thank you for visiting our new website. We hope that you are pleased with the new look and feel, functionality, and information that is now available. 

In early 2018 we started thinking of how we could provide the best possible experience for our clients and friends. While we continually evolve our Western Reserve Anesthesia Education conference materials, and the content on our Block Buddy application, we felt it was time to give our digital platforms a facelift.

After careful consideration, in March of 2018, we partnered with World Synergy, a Cleveland, Ohio-based marketing and applications firm to help us bring our ideas to life. Our new website has a clean, modern look that keeps users engaged with regular blogs and video updates. We hope that you enjoy the new website as much as we do. 

We look forward to providing you with the most beneficial information available and keeping you up to date on industry trends and new procedures.

Look for the release of an enhanced version of our Block Buddy application, Block Buddy PRO, with even more nerve block lessons, illustrations, and videos in the coming months.

Thank you,

Partners
Scott Urigel, MSN, CRNA
Jeff Molter, MSN, CRNA, MBA