General Information

• Hours: Monday to Friday, 5:30am to 2pm

  • Interns will take two call weekends and round on acute pain patients for a few hours.

  • Acute pain pager is shared among the team across the month.

  • The morning hours are the busiest as blocks need to be done prior to first start OR cases.

• Location: Seidman Pre-op (located past Mather PACU on 2nd floor)

• List of planned blocks gets emailed out the day prior.

  • Go to pharmacy by the OR control desk and ask for the appropriate number of ropivacaine and lidocaine syringes. Attending dependent, you may also need pre-filled precedex syringes.

• Morning setup:

  • Syringes, stopcocks, additives, block kits.

  • The senior on service will show you the ropes on the first day.

• Blocks:

  • Patients start arriving around 6am or earlier.

  • Once nursing has completed their check-in process, introduce yourself and begin consenting the patient.

  • This is a great time to practice IV skills. Establish IV access on your patients, ask for help if you’re ever in need.

  • Hook up monitoring, set up the block kit, position the patient. Be sure to do a time out with the nurse.

  • Once the attending shows up, perform the block! Depending on complexity and patient habitus, some blocks will be performed primarily by seniors.

  • Write a consult note and procedure note for each block. Make sure to put the ultrasound picture in the procedure note.

• Rounding:

  • We will round on any patient we placed a catheter for, any patient who is POD1 from surgery that we did a single shot block for, and any consult.

  • Print the list and write down the following: POD#, surgery, block we did, 24 hour opioid consumption.

    • Depending on the block, anticoagulation timing will also be important.

  • Take supplies with you on rounds, such as syringes, ropivacaine vials for bolus doses, and ropivacaine bags for pain pump refills.

  • See patients, pull catheters when appropriate, and write notes.

• Pain Pumps:

  • For patients receiving catheters, we will need to set up a pain pump. A senior will show you how to make and program them.

  • Once complete, deliver them to the appropriate ORs.

• Prepare for the next day

  • The OR schedule is typically ready by mid-morning. Typically Denise will sit down with the attending and decide on blocks for appropriate patients. It is a good learning experience to observe this process.

• Continue fielding consults and performing blocks that come up until 2pm. Typically interns are able to go home earlier than that :)