User:Ljpeterson

ACL & MULTI-LIGAMENT KNEE SURGERY- BLOCK PROTOCOL

-If patient has Both FEMORAL and SCIATIC Nerve Blocks: Sciatic site to be bolused in PACU (*after assessment of sciatic nerve funciton is assessed and documented) with 0.2% Ropivacaine 20ml
 * If staying in the hospital (IN-PATIENT):

1) Add 'Anes Peripheral Nerve Catheter Orders': Add only 1 order set, then click '+Add' (in upper left) to add additional block site orders

2)(check box, modify plan, add site to comments) FEMORAL Nerve Block: Ropivacaine 0.2%, initial rate 5ml/hr (no range for titrating),with bolus of 3ml every 30 mins

3)(+Add medication, modify plan, add site to comments) SCIATIC Nerve Block: Ropivacaine 0.2%, initial rate 5ml/hr (no range for titrating), with bolus of 3ml every 30 mins

4)(check box, modify plan, add site to comments) FEMORAL Nerve Block: Ropivacaine 0.2% OnQ Pump, rate of 8ml/hr, comment NOT FOR IV USE- HOME USE ONLY, place prior to inpatient pump discontinued

5)(+Add medication, modify plan, add site to comments) SCIATIC Nerve Block: Ropivacaine 0.2% OnQ Pump, rate of 8ml/hr, comment NOT FOR IV USE- HOME USE ONLY, place prior to inpatient pump discontinued

-If patient has ONLY FEMORAL Nerve Block:

1) Add 'Anes Peripheral Nerve Catheter Orders'

2)(check box, modify plan, add site to comments) FEMORAL Nerve Block: Ropivacaine 0.2%, initial rate 8ml/hr (no range for titrating),with bolus of 3ml every 30 mins

3)(check box, modify plan, add site to comments) FEMORAL Nerve Block: Ropivacaine 0.2%, initial rate 8ml/hr (no range for titrating),with bolus of 3ml every 30 mins

-If patient has Both FEMORAL and SCIATIC Nerve Blocks: Sciatic site to be bolused in PACU with 0.2% Ropivacaine 20ml
 * If discharging from PACU (OUT-PATIENT):

1) Add 'Anes Peripheral Nerve Catheter Orders': Add only 1 order set, then click '+Add' (in upper left) to add additional block site orders

2)(check box, modify plan, add site to comments) FEMORAL Nerve Block: Ropivacaine 0.2% OnQ Pump, rate of 8ml/hr, comment NOT FOR IV USE- HOME USE ONLY, place prior to inpatient pump discontinued

3)(+Add medication, modify plan, add site to comments) SCIATIC Nerve Block: Ropivacaine 0.2% OnQ Pump, rate of 8ml/hr, comment NOT FOR IV USE- HOME USE ONLY, place prior to inpatient pump discontinued

-If patient has ONLY FEMORAL Nerve Block:

1) Add 'Anes Peripheral Nerve Catheter Orders'

2)(check box, modify plan, add site to comments) FEMORAL Nerve Block: Ropivacaine 0.2% OnQ Pump, rate of 8ml/hr, comment NOT FOR IV USE- HOME USE ONLY, place prior to inpatient pump discontinued

TKA Surgery- Block Protocol 

-If patient has ONLY FEMORAL Nerve Block:

1) Add 'CAG Total Knee Replacement Nerve Catheter Orders'

2)(check box, modify plan, add site to comments) FEMORAL Nerve Block: Ropivacaine 0.2%, initial rate 5ml/hr (no range for titrating),with bolus of 3ml every 30 mins

3)Check box for the following order: communication order 'Starting on POD#2, turn off infusion at 0500'

4)Check box for the following order: Remove Indwelling catheter at "POD #2 at 1200. When removed...'

-If patient has Both FEMORAL and SCIATIC Nerve Blocks: Sciatic site to be bolused in PACU (*after assessment of sciatic nerve funciton is assessed and documented) with 0.1% Ropivacaine 5-10mls

1) Add 'CAG Total Knee Replacement Nerve Catheter Orders': Add only 1 order set, then click '+Add' (in upper left) to add additional block site orders

2)(check box, modify plan,add site to comments) FEMORAL Nerve Block: Ropivacaine 0.2%, initial rate 5ml/hr (no range for titrating), with bolus of 3ml every 30 mins

3)(check box, modify plan, add site to comments) SCIATIC Nerve Block: Ropivacaine 0.1%, initial rate 3ml/hr (no range for titrating), with bolus of 3ml every 30 mins

4) Check the following boxes: communication order 'Starting on POD#2, turn off infusion at 0500' & write in comments 'for both blocks'; Remove Indwelling catheter at "POD #2 at 1200. When removed...' & write in comments 'for both blocks'; Ambulate with assistance; sciatic infusions 'only start when patient has full range of motion...'; sciatic infusions 'stop infusion if patient develops foot weakness...'