• Should receive an email about potential blocks the day before. The patient’s chart should be reviewed for suitability for block. If concerns exist, reach out to the staff in that patient’s OR
• The email list of patients may over or under capture patients for blocks
• If you will need help with a particular block, reach out to the Block Coordinator
• If you are overwhelmed with the number of blocks to be done, call the Block Coordinator or the patient’s Anesthesiologist in OR to help
Day in block room:
• Get the 7861 phone in the Department large conference room
• Get sedatives from the drug machine (midazolam and fentanyl)
• Patients will arrive to the block room between 7:15-8:00am
• Patient will need to be checked in by a nurse from the OR prior to commencement of block
• Perform the block and document on iPRO (documentation can be done after patient is brought to OR)
• Will receive calls from OR nurse for timing around sending for the next patient for blocks. The OR list should be reviewed for potential blocks and discussed with Anesthesiologist in OR.
Rescue blocks:
• Surgical incisions/plans may change or the patient may wake up with more pain than anticipated. The anesthesiologist from the OR may request for you to assess and consider a regional technique for pain management
APS patients
• Member of APS team will call the block phone with a request for nerve catheter insertion
• Details will be provided to you including the MRN and reason for the block
• Other important details to ask include: location of patient (ED/ICU/ward), isolation/precaution status, spine clearance (if applicable), and other contraindications for the procedure\
• Give a time to the APS team member for when the patient should be sent to the block room. Keep in mind there may be delays with the porter system and transfers may take up to 1 hr. Please communicate with Block Room AA on timing for APS patient.
• Once block is done, hand write the order for the nerve catheter infusion in the patient’s chart (see details in APS manual for standard infusion orders)
• Text page APS/page APS after completion of block and provide details on procedure performed
• Patient’s ward and room number is then given to the porter next to the block area for transfer back to the ward
• Ensure a billing card is stamped for the patient with you and the billing staff written on the card (not the block room coordinator)
** MODIFIERS FOR APS PATIENTS
• Blocks for ICU patients are to be done in the ICU with the assistance from APS NPs, not Block Room AA
• Patients in isolation/precaution or on outbreak wards should have their procedure done on the ward. If a patient is done in the block room, environmental services needs to be called for a terminal clean
• AAs are present in the block room until 3pm. If a block is expected to go beyond 3pm, it is your responsibility to arrange for help from APS NP before starting the block
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