Jeff Gadsden
@jeffgadsden
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@DukeU Anesthesiologist and #Acutepain physician. Stamping out acute pain one nerve block at a time. #DukeRAP #FOAMed #POCUS
Durham, NC
Joined May 2014
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We all have fave central line approaches...given a choice, I do prefer the subclavian. It's just so reliable, esp in hypovolemia/shock. If you haven't done one in a while (or like many of our trainees, have NEVER done one) check out this refresher!
23
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On Day 2 of
#blocktober
, we'll be taking a deep dive on the PENG (Pericapsular Nerve Group) block. This technique has very effective for hip fracture pain as well as pain following THA or arthroscopy. It's also an easy block to teach and learn. How are you using PENG?
#DukeRAP
7
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Happy 1st of
#Blocktober
to all you blockstars out there!! It's SOOO great to be back and looking forward to all the fun interaction and engagement with the RA community!!! Check out today's block and more in the 🧵 below
#DukeRAP
@Duke_Anesthesia
@ASRA_Society
@ESRA_Society
9
85
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Heard about another case of IV lido infusion causing cardiac arrest on a post-op floor. Horrible outcome, esp since there are a variety of better/safer solutions for acute pain mgmt. If you need a refresher on LAST, including IV lido mgmt, watch this 👇
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Struggling with what to do with patients on GLP-1 agonists like
#ozempic
? Even if off for a week, we're still finding some have full stomachs on day of surgery. 🤦♂️
Check out this new video on gastric POCUS--a critical tool to help decision-making:
11
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Haaaaaappy
#Blocktober
!!!! Can't believe it's back already! We're going to kick things off with the subgluteal sciatic nerve block -- a very handy technique that we do regularly for a variety of lower limb procedures.
#DukeRAP
#blocktober
#regionalanesthesia
19
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Good morning
#blocktober
friends! On our 19th day we'll discuss the suprainguinal fascia iliaca (
#SIFI
), a useful technique that confers quality analgesia and improves outcomes for patients with hip fracture. We also use it for THA. What are you using this for?
#DukeRAP
#FOAMEd
11
79
186
It's Day 2 of
#blocktober
! Thanks for the amazing engagement yesterday!! Today we're drilling down on the adductor canal block and how best to maximize efficacy and safety. Our technique has changed over the years..has yours?
#DukeRAP
#FOAMed
#MedEd
#Regionalanesthesia
12
73
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I started doing adductor canal blocks 10 yr ago...and things have definitely changed in that time. Check out our updated vid for a look at the evolution of the block and best practices for getting optimal results from it. Enjoy!
@amit_pawa
@EMARIANOMD
6
60
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On day 6 of
#blocktober
we’re going to look at a modern classic: the TAP block. A relatively simple technique, it’s found a solid place in the pantheon of blocks. Today we’ll go over the sonoanatomy and some tips and tricks for success. What are your top TAP tips??
#DukeRAP
5
71
170
Hi
#Blocktober
friends! On day 5 we'll be looking at ultrasound for neuraxial procedures. It's a great tool to have in your back pocket, esp when caught off guard by that unexpectedly tricky spinal or lumbar puncture. How often are you using US to image the spine?
#DukeRAP
5
65
167
We're a full week into
#Blocktober
!! For Day 7, we discuss the interscalene brachial plexus block, an old-school block that remains a go-to for shoulder, clavicle and upper arm surgery. We also share some tips for minimizing the risk 4 complications.
#DukeRAP
#RegionalAnesthesia
7
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152
Happy to see our genicular nerve block study in print! Doing these blocks with 0.25% bupi/dexamethasone reduced 24h opioid use by 60% compared with sham blocks, and have been a useful and easy addition to our complement of blocks for TKA!
#DukeRAP
#TKA
@MillyRambhia
@DukeOrtho
12
59
155
Good morning and happy
#blocktober23
!! Can't believe it's been a whole 11 months. 🤯 Looking forward to a month of engagement, ideas, and discussion!
@Nadia_Hdz_MD
@garyschwartzmd
@Steve_Coppens
@Ropivacaine
@MKwesiKwofie
@BridgetPulos
@anesthesiadocmd
@bobfunn
@NarouzeMD
13
51
155
It's here! Happy
#Blocktober
everyone!! On Day 1 we start things off with a discussion of the iPACK block, which has been shown to improve early pain scores, knee ROM, ambulation distance and satisfaction in several TKA studies.
#dukerap
#FOAMed
#MedEd
(1/3)
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Hungry for some free education? Stop by
#DukeRAP
for our Value-Sono-Meal! And follow the
#blocktober22
fun starting soon!
@Duke_Anesthesia
@amit_pawa
@EMARIANOMD
@KalagaraHari
@ASRA_Society
@dr_tgro
@HoltzMaggie
@ajrmacfarlane
@claralexlobo
@MKwesiKwofie
@anesthesiadocmd
23
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Hi
#blocktober
peeps! It's day 9 and today we're going to look at continuous spinal anesthesia, an underutilized technique that we use to get some very sick people through surgery. It's safe, easy and very effective...how are YOU using continuous spinals?
#DukeRAP
#trauma
#hipfx
12
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Long foot/ankle cases under pop/saph block eventually get tourniquet hypertension. Our DB-RCT showed a small dose of mepivacaine near the fem vessels significantly reduces intra-op HTN & esmolol req'd to treat it by 92%.
8
34
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Happy Friday, the 22nd of
#blocktober
! Today we’re discussing thoracic paravertebral block—IMO the gold standard for thoracic analgesia (apologies to ESP lovers). Once intimidating, ultrasound has made it a much more user-friendly technique! How are you using PVB?
#DukeRAP
6
45
136
Watching
@EMARIANOMD
speak is such a pleasure...he's so compelling. For the last couple of minutes, I've found myself nodding my head and agreeing with his logical arguments...before remembering that supposed to be debating him. 🤦♂️
#ANES20
#regionalanesthesia
9
14
133
Good morning! We're 23 days into
#blocktober
and today we're discussing US guided ankle blocks! Advantages include ⬇️LA volume, ⬆️rates of successful surgical anesthesia, and improved patient experience! Easy to pick and choose your nerves cafeteria-style.
#DukeRAP
#Blocktober
5
46
132
Hey hey its
#blocktober
17th! Today we’re looking at the cervical plexus block, a technique that is simple, safe but very effective—awake carotid surgery? No problem! Also a great adjunct for thyroid, clavicle, shoulder and breast surgery. How are YOU using this block?
#DukeRAP
16
50
129
It's the 15th day of
#blocktober
! Today we're discussing ultrasound guided blocks of the nerves in the distal upper extremity: median, ulnar and radial. Great for hand surgery and also as a rescue block. What are you using these for? Enjoy!
#DukeRAP
#RegionalAnesthesia
#FOAMEd
11
45
128
Good morning
#blocktober
friends! Today we'll discuss the serratus plane block, another fascial plane block of the chest wall that we primarily use for rib fractures, but also has utility for a variety of other chest wall procedures.
#DukeRAP
#RegionalAnesthesia
#FOAMEd
2
48
125
Xmas baking (errr...eating) has got me thinking ESP blocks (
#regionalnerd
)...ES muscle fibers are like puff pastry; needle-TP contact often = expansion WITHIN the muscle layers, not beneath. Tip slightly caudad to TP = truly sub-fascial & ⬆️ consistency (in my hands).
#DukeRAP
15
50
127
It's the 29th of
#blocktober
! Today we talk phrenic-sparing blocks for shoulder surgery in pts who won't tolerate a hit to their pulmonary mechanics. Both suprascap and axillary NB are easy to perform and appear to provide non-inferior analgesia to ISB. Your thoughts??
#DukeRAP
6
37
125
Hey y'all, it's the 22nd day of
#blocktober
! Today we're discussing a staple of upper limb blockade, the supraclavicular brachial plexus block. The "spinal of the arm", this workhorse is a go-to for everything from shoulder to digit surgery.
#DukeRAP
#FOAMEd
#RegionalAnesthesia
3
50
124
Our ultrasound machines have new names. Came in today and Rose was missing, probably lost wandering around the OR somewhere. Classic.
#DukeRAP
11
8
121
Good morning
#blocktober
people! Today we're talking all things RAPTIR (Retroclavicular Approach to the Infraclavicular Region)! What are your experiences with this block? Love it? Hate it? Haven't tried it? Post your opinions!
#DukeRAP
#RAPTIR
#ANES20
#FOAMed
#Regionalanesthesia
9
55
119
It’s the 29th day of
#blocktober
! Ever struggle with blocks for the upper abdomen? The external oblique intercostal block is a new technique that provides reliable coverage of both the midline & lateral upper quadrant. We use it for subcostal incisions--how about you?
#DukeRAP
9
43
119
Hey it's the 28th day of
#blocktober
!! Today we're talkin' ESP blocks--anatomy, mechanism, technique & tips. ESP seems to be quite versatile, & comparative studies show comparable effect to many other block techniques, while being easy and safe. What are your thoughts?
#DukeRAP
7
46
116
In our observational study, we found blocks worked 100.0% of the time when the US machine was festooned with holiday cheer. More importantly, patient satisfaction scores ranged from “jolly” to “merry”. 🎅🏻🎄
#DukeRAP
@Duke_Anesthesia
@ASRA_Society
9
19
114
It’s the 26th of
#blocktober
! Today we're looking at the stellate ganglion block! This technique that used to be risky and inconsistent has been made simple and reliable with ultrasound guidance, and is used to treat pain, vascular insufficiency, arrhythmias & more.
#DukeRAP
9
44
112
It's the 31st of
#Blocktober22
! A few things before we say goodbye--please follow along on this 🧵. First, a MASSIVE thank you to everyone who engaged, tweeted, commented, and debated throughout the month--SOOO wonderful to see what an amazing community we have in RAAPM!!
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20
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Please enjoy our final video for
#blocktober
2020
@MKwesiKwofie
@James_Kim_MD
@HoltzMaggie
@ajrmacfarlane
@galusweegie
@UltrasoundMD
@zedunow
@Nadia_Hdz_MD
@claralexlobo
@SreeHPraveenKO1
@rosie_hogg
@dr_melissabyrne
@nelkassabany
@lipidguy
31
27
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Not every day a trainee "hits for the cycle", but this week our fellow
@GMaquoit
performed ALL of these in ONE day: 1) interscalene 2) supraclav 3) infraclav 4) axillary 5) elbow block 6) digital block.
#crushingit
#DukeRAP
@Doctor_JRD
@Duke_Anesthesia
@DukeAnesRes
7
13
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@VeenaGraffMD
@Nadia_Hdz_MD
@James_Kim_MD
@EMARIANOMD
@nelkassabany
@dr_rajgupta
@shaskinsMD
@BryantTranMD
@EHigginsMD
@kchopraMD
@dr_tgro
@SreeHPraveenKO1
@amit_pawa
I think this pretty much covers what we do...
20
20
109
Happy 13th of
#blocktober
everyone! Today we're taking it back to basics: peripheral nerve anatomy. It's important to have a clear understanding of the structural of peripheral nerves in order to perform nerve blocks as safely as possible. Enjoy!
#DukeRAP
#RegionalAnesthesia
6
45
106
Happy
#blocktober
16th! Today we’re talking about LAST—what it is, what it looks like, and how to prevent and treat it. If you use enough local anesthetic, you’ll end up with a LAST story—what’s yours?
#DukeRAP
@ajrmacfarlane
@elboghdadly
@KiJinnChin
@NarouzeMD
@SreeHPraveenKO1
3
45
106
And here's the video for the PENG (Pericapsular Nerve Group) Block. Enjoy ur Saturday!
#blocktober
#DukeRAP
@PeterMerjavy
@HoltzMaggie
@rosie_hogg
@elboghdadly
@RegionalAnaesUK
@DrEAlbrecht
@Anaes_Journal
@NarouzeMD
@MKwesiKwofie
@ChrisPrabhakar
4
48
105
It's day 13 of
#blocktober
and today's block is the popliteal sciatic, a workhorse technique that has a ton of indications. Nothing is as satisfying as watching the sheath fill up with local anesthetic as you inject. What role does it have in your practice?
#DukeRAP
2
33
106
Yo yo, it's the 19th of
#blocktober
, and that means rectus sheath blocks! This old school technique has enjoyed a resurgence and is now part of some of our ERAS pathways for abdominal cases with midline incisions. Also a fave for urgent ex-laps when TEA contraindicated.
#DukeRAP
6
38
104
It's Day 2 of
#Blocktober22
! Hope you're having a relaxing Sunday! Check out today's 🧵 and join in with your thoughts and experiences using today's block! 👇 👇
#DukeRAP
@Duke_Anesthesia
@ASRA_Society
@ESRA_Society
@AoraIndia
@LasraAnestesia
@ASALifeline
@AFSRA10
5
39
102
Yo yo it's
#Blocktober
the 4th! Today we're going to shift to the lower limb with a personal fave of many...follow the 🧵 to join in!
@ASRA_Society
@ESRA_Society
@LasraAnestesia
@AoraIndia
@AFSRA10
@ASALifeline
@amit_pawa
@EMARIANOMD
@KalagaraHari
@HoltzMaggie
@rljohnsonmd
6
37
99
Happy
#Blocktober
24th! Let's talk parasternal blocks! Multiple names/approaches but essentially one deep and one superficial--both block the ant. cutaneous IC nerves, and benefit breast, cardiac & trauma patients. What are your thoughts on these?
#DukeRAP
#RegionalAnesthesia
6
38
97
I am thrilled to share that the
@Duke_Anesthesia
graduating residency class of 2020 has chosen
@amandahkumar
as Educator of the Year!!! Dr. Kumar is a tremendously gifted and passionate teacher and this is SO well-deserved! Congrats Amanda and to the class of 2020!! 👊🏻🎉🎉
13
10
97
Good morning
#blocktober
friends! Today (the 18th) is QL day! We’ll discuss the anterior approach to the QL block, and go over anatomy, sonoanatomy and technique. It’s found a place in our practice for big abdominal cases, but it has a number of other indications too.
#DukeRAP
3
42
96
Hey hey it’s the 2nd day of
#Blocktober23
and we’re talking suprascapular nerve block. We do this when we’re concerned about phrenic nerve block in at-risk patients, and will combine it with an axillary nerve block or an infraclavicular BPB. Surprisingly effective? Yup.
7
43
96
It's the 6th of
#Blocktober22
and it's ALSO
#ThrowbackThursday
!! ICYMI, we've discussed a number of chest wall blocks in prior
#blocktober
seasons...what's your fave? Follow the 🧵below to chime in!
#DukeRAP
@ASRA_Society
@ESRA_Society
@ASALifeline
@LasraAnestesia
@AoraIndia
1
35
94
Outstanding talk by
@amit_pawa
showing that multilevel PVB and PECS both cover the axilla (ie T2 & T3). We’ll often add a PECS2 (aka pectoserratus) to infraclavicular for AV fistula creation when the surgeon plans on creeping up into the armpit
#ESRA2022
@KiJinnChin
@EMARIANOMD
4
22
94
This 19th of
#blocktober
, we’ll take a step back and review nerve blocks for TKA. There are different combos of PNBs available, and in this video we’ll describe a deconstructed anatomical approach to making your patients happy and mobile!
#DukeRAP
10
37
93
If only I was this good at blocking nerves....
@UltrasoundExpe1
@PeterMerjavy
@galusweegie
@KalavaMd
Why wasn't this on my
@Duke_Anesthesia
visiting prof agenda??
@jeffgadsden
@ankeetudani
1
0
11
20
4
91
Hey
#blocktober
nation! It's our final day. Thank you all so much for your engagement--it's been an incredibly fun month!
#DukeRAP
#RegionalAnesthesia
#FOAMEd
21
6
92
Tired of nomenclature confusion? QL3? Anterior approach? Tequila? I'm just gonna call it the Porterhouse Block. "insert the needle thru the NY strip until you get to the filet mignon..."
#mmmm
#dukerap
#apologiestovegans
5
28
90
It's two weeks away. We're pretty excited. (better with sound)
#DukeRAP
#Blocktober
@Duke_Anesthesia
@ASRA_Society
@ESRA_Society
@EMARIANOMD
@amit_pawa
@KalagaraHari
@HoltzMaggie
@ajrmacfarlane
@claralexlobo
@nelkassabany
@NarouzeMD
@MKwesiKwofie
@Steve_Coppens
@James_Kim_MD
17
24
91
Hey it's
#ThrowbackThursday
! ICYMI,
#DukeRAP
have put together some instructional block vids...check out our lower limb series below.
@amit_pawa
@EMARIANOMD
@James_Kim_MD
@MKwesiKwofie
@KalagaraHari
@ajrmacfarlane
@HoltzMaggie
@Nadia_Hdz_MD
@James_Kim_MD
1
38
90
@ASRA_Society
@ESRA_Society
@LasraAnestesia
@AoraIndia
@AFSRA10
@ASALifeline
@amit_pawa
@EMARIANOMD
@KalagaraHari
@HoltzMaggie
@rljohnsonmd
@mswami001
@Duke_Anesthesia
@zedunow
@AmyPearsonMD
@NarouzeMD
@JensBorglum
@James_Kim_MD
@nelkassabany
@dr_tgro
@dr_rajgupta
Today we're talking about the anterior approach to the sciatic nerve block--great for when you just can't turn the patient on the side or elevate the leg.
#Blocktober22
#DukeRAP
@AmandaKumarMD
@PeterMerjavy
@ajrmacfarlane
@athmathottungal
@MKwesiKwofie
@SretroPMD
@SreeHPraveenKO1
6
36
86
Happy Monday,
#blocktober
friends! Today we discuss the femoral and lateral femoral cutaneous nerve blocks--we use these for lower limb trauma, ACL repair, and amputation, as well as the occasional complex TKA patient. How about you?
#DukeRAP
#RegionalAnesthesia
#FOAMed
4
39
85
It’s the 8th day of
#blocktober
and today we’re taking a look at the ilioinguinal and iliohypogastric nerve blocks! A tried-and-true technique for inguinal hernia repair and other procedures in the inguinal/suprapubic region, it’s easy, safe and effective.
#DukeRAP
2
38
87
Hey hey it's the 12th day of
#Blocktober22
! Today we'll be exploring a way to prolong those blocks beyond the usual 12-18 hours...follow the 🧵 below to follow along and chime in!
#DukeRAP
@ASRA_Society
@ESRA_Society
@AoraIndia
@LasraAnestesia
@AFSRAsociety
@ASALifeline
5
21
85
Oh boy, less than 5 hours to go until
@EMARIANOMD
and I face off again in round 2 of what I'm calling the "Argumentum at the Ligamentum". Are you
#TeamFascial
or
#TeamEpidural
? Join us at
#ANES20
, you may find yourself changing sides!!
9
19
84
Hey hey! It's the 3rd of
#Blocktober22
and today we're going to focus on a core block for pediatrics--check out the 🧵 below!
@ASRA_Society
@ESRA_Society
@LasraAnestesia
@AoraIndia
@ASALifeline
@Duke_Anesthesia
@AFSRA10
@PediAnesthesia
@PedsPainMed
@PedsAnesthesia
#DukeRAP
4
25
84
@Nadia_Hdz_MD
@garyschwartzmd
@Steve_Coppens
@Ropivacaine
@MKwesiKwofie
@BridgetPulos
@anesthesiadocmd
@bobfunn
@NarouzeMD
@amit_pawa
@EMARIANOMD
@fuzzymittens
@AmyPearsonMD
@ASRA_Society
@dr_rajgupta
@galusweegie
@ruthi_landau
@ajrmacfarlane
@claralexlobo
@nelkassabany
@athmathottungal
@docmorne
@ChrisPrabhakar
@VeenaGraffMD
@James_Kim_MD
@KohanLynn
@lipidguy
@GongGasGirl
@mokaeleni
@lianazucco
@rljohnsonmd
@jon_bailey_anes
@KalagaraHari
@blockergirlMD
Do YOU use neuraxial ultrasound on a regular basis? Or just pull it out when you've been sweating for 45 minutes (yep, guilty as charged)...any cool tips or tricks you can share with the world?
#blocktober23
@hjas18anes
@_anapatriciaper
@BarbaraVersyck
@AminaBenyoucef5
29
16
80
Yo, it’s the 3rd day of
#Blocktober23
and I wanna talk about fat. Specifically the kind that saves lives during LAST. In my view, lipid emulsion is one of the most significant advances in acute care medicine in the last 20 years. (Yes, that's lipid latte art...delicious & safe)
6
31
80
Tomorrow begins my fave month:
#Blocktober
! (credit:
@BryanChowMD
) To celebrate in style,
#DukeRAP
will be sharing a different tip/trick/video/poll/etc each morning over the next 31 days. Stay tuned!!
@Duke_Anesthesia
@ASRA_Society
@ESRA_Society
6
33
79
4
34
76
Good morning
#Blocktober22
friends and greetings from the Big Easy!
#ANES22
Today we're going to be reviewing an ultrasound-guided technique that we use to augment analgesia after TKA...follow along below!
@ASRA_Society
@ESRA_Society
@AoraIndia
@LasraAnestesia
@ASALifeline
4
25
78
Question for anyone doing total knees/hips: I'd like to know which centers are doing: 1) infiltration by surgeon alone; 2) infiltration plus single shot adductor by anesth; 3) just blocks by anesthesiology. Also, if you've done more than one style, what's best in ur opinion? Thx!
71
28
77
@ASRA_Society
@ESRA_Society
@AoraIndia
@LasraAnestesia
@ASALifeline
@amit_pawa
@EMARIANOMD
@KalagaraHari
@Duke_Anesthesia
@anesthesiadocmd
@rafrussodoc
@fuzzymittens
@GongGasGirl
@mswami001
@NarouzeMD
@dr_rajgupta
@MKwesiKwofie
@Jerryblocksthat
@jon_bailey_anes
@Nadia_Hdz_MD
@SreeHPraveenKO1
@HoltzMaggie
@dremilym
@colinjmccartney
@rosie_hogg
@ajrmacfarlane
@MariaaYasminee
@dr_tgro
@VeenaGraffMD
@DrJeniMD
@ebmalinzakMD
@vheldens
@chk29
@NualaSchwartz
@Roques_V
@blockergirlMD
@MaryJHargett1
@HSSAnesthesia
@Steve_Coppens
@Cano_Pen
@bfsallen
@VUMC_Anes
@MayoAnesthesia
@rljohnsonmd
@BridgetPulos
@SLKoppMD
@galusweegie
@MonikaNandaMD
Here's our last video of
#Blocktober22
. Thanks again for watching and engaging!! Enjoy!
@DrBluesNYC
@NYSORA
26
29
77
Ok, we're going to start things off with an ol' classic--the axillary brachial plexus block. Who loves them some axillary scanning?! We do!! Check out our video here:
#DukeRAP
#Blocktober22
4
33
76
Hellooooo
#Blocktober22
friends! It's day 17, & today we want to hear from all you amazing clinicians and educators: What is your BEST tip/trick/hack/advice/pearl for
#RegionalAnesthesia
newbies? Please share!
@ASRA_Society
@ESRA_Society
@AoraIndia
@LasraAnestesia
@ASA_Australia
30
27
75
@ASRA_Society
@ESRA_Society
@LasraAnestesia
@AoraIndia
@ASALifeline
@amit_pawa
@EMARIANOMD
@Duke_Anesthesia
@KalagaraHari
@HoltzMaggie
@AFSRAsociety
@megs1970
@MariaaYasminee
@NarouzeMD
@dr_rajgupta
The clavipectoral fascial plane block is a relatively new technique designed to do one thing: anesthetize the clavicle. Great for clavicle fracture repair when you DON'T want to block the whole arm...
#Blocktober22
@fuzzymittens
@zedunow
@Docbasia
@colinjmccartney
@Jerryblocksthat
5
21
74
Hey it's the 12th day of
#blocktober
and we're talking PECS blocks--a very useful fascial plane technique that's been shown to improve recovery and provide comparable analgesia to paravertebral blockade. What's been YOUR experience? Chime in!
#DukeRAP
#RegionalAnesthesia
8
28
73
And here's the video. Enjoy!!
#blocktober
#DukeRAP
@docmorne
@cjlmcc
@YmaGrebnesi
@DoctorJesseMD
@HoltzMaggie
@James_Kim_MD
@ZeNicoLs
@DrNatStrand
@BarbaraVersyck
@pritanand
@Wilkinsonjonny
@jon_bailey_anes
@lipidguy
@katieearendt
@DrJeniMD
7
37
74
@ASRA_Society
@amit_pawa
@EMARIANOMD
@megrosenblatt
@KalagaraHari
@Steve_Coppens
@ASA_Australia
@L_D_White
@Wilkinsonjonny
@jon_bailey_anes
It’s a relatively simple block, but it can be tricky to get the perfect image. Here’s a handy tip to help direct your US beam to the right spot every time.
#Blocktober23
@GongGasGirl
@MKwesiKwofie
@ajrmacfarlane
@docmorne
@rljohnsonmd
@Duke_Anesthesia
9
24
73
@amit_pawa
doing a fantastic job as always explaining how guidelines in hip fracture care have improved outcomes in this vulnerable population.
#ASRASpring23
#asra100
@ASRA_Society
@EMARIANOMD
@ajrmacfarlane
@anesthesiadocmd
@HoltzMaggie
@KalagaraHari
@garyschwartzmd
9
16
73
It's the 21st day of
#Blocktober
! Today we discuss ways to stay out of trouble--and more specifically, out of the nerve. Needle-nerve contact is known to cause inflammation and injury, and we can use several monitors to prevent getting too close.
#DukeRAP
#RegionalAnesthesia
3
25
72
Happy Saturday
#Blocktober22
family! It's day 8, and today we're going to stick with the brachial plexus...let's see...what haven't we covered?? 🤔Follow the 🧵below to find out and chime in!
@ASRA_Society
@ESRA_Society
@LasraAnestesia
@AoraIndia
@AFSRAsociety
@ASALifeline
3
26
69
Good morning! It's the 20th of
#Blocktober22
and it's also, once again,
#ThrowbackThursday
! Today let's talk about the various upper limb blocks that we've discussed over the years--what's your fave and why?
@ASRA_Society
@ESRA_Society
@amit_pawa
@EMARIANOMD
@KalagaraHari
5
30
69
Morning! It's
#Blocktober
13th and it's also
#ThrowbackThursday
!! Today let's talk about all our fave lower limb block techniques--what's the one you CAN'T live without?? (best with 🔊)
@ASRA_Society
@ESRA_Society
@LasraAnestesia
@AoraIndia
@ASA_Australia
7
30
68
Happy 4th day of
#Blocktober23
! Let’s talk knees: We love our adductor/ipack/genics combo for TKA, but what about the cutaneous nerves? Are they important? I mean, it’s just skin, right?
@ASRA_Society
@amit_pawa
@EMARIANOMD
@Steve_Coppens
@drrobbieerskine
@bobfunn
@VeenaGraffMD
5
25
68
Today we'll be talking about ultrasound guided intercostal nerve blocks--an excellent technique for all kinds of chest (& abdominal) indications. Broken ribs? this is a quick, easy and effective technique to have at your disposal:
#DukeRAP
#Blocktober22
3
35
67
But wait, there's more! Ever find you've done a great axillary BPB, but the surgeon has to cut up in the axilla? Been there. That's why you need a good approach to the intercostobrachial & med brachial cutaneous nerve. Check out this vid:
#blocktober22
5
19
64
Hey
#Blocktober
friends! It's Day 5 and today we'll talk about a technique that is over 100 years old, but still has a lot of utility in today's RA practice...follow the 🧵 below for more...
#DukeRAP
@ASRA_Society
@ESRA_Society
@LasraAnestesia
@AFSRAsociety
@Duke_Anesthesia
5
21
64
We at DukeRAP have been THRILLED to work w/ doctors from Secção de Internos do Clube de Anestesia Regional (
@CAR__internos
), the residents section of the Portuguese Society of RA and Pain Therapy (CAR/ESRA) to bring you 10 new Portuguese videos!! 🧵
@CAREsraPortugal
@claralexlobo
4
14
65
So great to hear Emily Lin from
@MSKCancerCenter
showing how both ESP & PV blocks reduce LOS and opioid use vs surgical infiltration in autologous breast recon. My hot take? Surgeons should stick to snippy snippy, and leave analgesia to the experts 😉.
#ASRASpring23
6
16
64
Hey it's the 16th of
#Blocktober22
and--in response to some excellent chatter yesterday--we're doing a Mythbusters episode! Follow the 🧵 below to find out more...
@ASRA_Society
@ESRA_Society
@LasraAnestesia
@AoraIndia
@ASALifeline
@ASA_Australia
2
18
63
Great stuff from
@rljohnsonmd
regarding TXA—only need to use in 3-4 patients to save a transfusion, but would have to give in ~1000 patients to get a VTE.
#ANES19
1
30
60
@VeenaGraffMD
@Steve_Coppens
@dr_rajgupta
@EMARIANOMD
@theRodrigoDaly
@mick_kerr
@garrettsbarry
@jon_bailey_anes
@BlockIt_Hot_Pod
@Ropivacaine
@glauncel
@anesthesiadocmd
@PeterMerjavy
@rljohnsonmd
@KalagaraHari
@ButterflyNetInc
@amit_pawa
@dr_tgro
@HoltzMaggie
I’ll say it again: when the attending/consultant surgeon does every single part of the case his/herself and doesn’t allow trainees to close for 30+ mins, I MAY re-order my priorities. Until then, they remain: 1) pt safety 2) pt comfort 3) trainee experience and THEN efficiency
4
14
61
Great question from
@KiJinnChin
: would you do PV blocks in an anticoagulated patient? Various answers being discussed here. My personal opinion is yes. Benefit >>> risk in vast majority of cases. Plus, risk isn’t spinal bleed, it’s PV hematoma
#ESRA2022
@amit_pawa
8
12
61
Wassup
#Blocktober22
friends, it's day 7! Today we're going to re-visit a different take on a classic brachial plexus block...follow the 🧵 below to find out more!
#DukeRAP
@ASRA_Society
@ESRA_Society
@LasraAnestesia
@AoraIndia
@AFSRAsociety
@ASA_Australia
@ASALifeline
6
28
60
Finally got more stickers...we've found these a useful "just-in-time" educational tool for reviewing blocks on the fly. QR code takes you to the videos. If anyone wants these for block area/ultrasound machines/fridge, DM me and I'll mail you some wherever you are!
#DukeRAP
13
11
60
Been off twitter for a couple of weeks, but delighted to come back to see that
@Vapourologist
has created a month-long airway education event called
#JanuAirway
!! Awesome name 😂 & concept! A must-follow for all anesthesiologists!
#FOAMEd
@dasairway
@RCoANews
@ASALifeline
3
18
61
Hiya! It's the 16th of
#Blocktober23
and also
#WorldAnesthesiaDay
! Today we're discussing stellate ganglion block: a wildly versatile technique that has applications not only pain medicine, but for managing arrhythmias, hot flashes, vascular insufficiency, anosmia, etc....
4
17
61
And here's the video for ESP blocks. Really interested to your thoughts--are you using this? For what? Successes and failures?
#blocktober
#DukeRAP
#FOAMEd
#RegionalAnesthesia
@SreeHPraveenKO1
@kaohesham
@sanjibadhikary
@Ropivacaine
8
33
61
Hiya, it's the 18th day of
#Blocktober22
and today we're talking about a block used for upper limb trauma...you ARE doing blocks for trauma right? Follow along this thread to find out more and to chime in!
@ASRA_Society
@ESRA_Society
@LasraAnestesia
@AoraIndia
@ASALifeline
5
22
60
Grateful to be able to release 4 more block videos translated/subtitled by
@dr_tgro
and his team of 🇺🇦 collaborators. 🙏 Hopefully can be a resource for docs in Ukraine. Please see link to playlist below.
#StandWithUkraine
6
15
60
@Nadia_Hdz_MD
@garyschwartzmd
@Steve_Coppens
@Ropivacaine
@MKwesiKwofie
@BridgetPulos
@anesthesiadocmd
@bobfunn
@NarouzeMD
@amit_pawa
@EMARIANOMD
@fuzzymittens
@AmyPearsonMD
@ASRA_Society
@dr_rajgupta
@galusweegie
@ruthi_landau
@ajrmacfarlane
@claralexlobo
Today I thought we could start by talking about an extremely useful tool that I probably don't use often enough...neuraxial ultrasound.
#blocktober23
@nelkassabany
@athmathottungal
@docmorne
@ChrisPrabhakar
@VeenaGraffMD
@James_Kim_MD
@KohanLynn
8
26
60