A Nurse Practitioner and a Chiropractor walk into a procedure room and...stellate ganglion block

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Ligament

Ligament

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scared stephen colbert GIF
 
No sterile gloves, no sterile ultrasound cover, no masks, zero patient monitoring, pulling off the cap and holding the syringe underhanded with two hands (with zero hands on the flange or plunger), letting go of the syringe/needle mid-procedure, pushing the plunger with both thumbs, "ultrasound eliminates ANY of the risks and side effects", recapped the needle, holding the needle with crossing over it with the other arm to clean the neck, with paper towel, then continues to hold the needle for another 10 minutes.

My eyes are bleeding.
 
Ferrismonk said:
No sterile gloves, no sterile ultrasound cover, no masks, zero patient monitoring, pulling off the cap and holding the syringe underhanded with two hands (with zero hands on the flange or plunger), letting go of the syringe/needle mid-procedure, pushing the plunger with both thumbs, "ultrasound eliminates ANY of the risks and side effects", recapped the needle, holding the needle with crossing over it with the other arm to clean the neck, with paper towel, then continues to hold the needle for another 10 minutes.

My eyes are bleeding.
Click to expand...
Forgot to mention 1) no training nor qualifications for the nurse 2) chiropractor running the ultrasound machine
 
This procedure is indeed a disaster. But let's also give some credit to the remarkably poor way the pt's psych issues (ie the supposed rea$on the NP/chiro decided to do a $tellate) were addressed. This medical Abbott and Costello duo offer a fairly well-rounded menu of insanity:

Appetizer: Watching the NP repeatedly confuse xanax and prozac yet insinuate she was comfortable prescribing and managing both. Bonus points for suggesting xanax is safer than prozac. Even more points for not encouraging the patient to, you know, see a psychiatrist.

Aperitif: Asking the patient to recall the events that trigger his PTSD right before they stick a needle in his neck.

Main course: A raging dumpster fire of an injection, as described in posts above.

Dessert: A delicious array of (mostly) horrendous and tangential analogies to try describe PTSD to a patient -- delivered by a bumbling, confused chiro. His persistence and ability to not give up for over 7 minutes should be commended.

I hope the psychiatrists watch this and leave comments on the youtube page. Of course, that assumes they're still alive after their heads exploded right around ~13:51.
 
I love how she announces that she “aspirated first” prior to injecting. Totally oblivious to the safety disaster she was involved in.
 
Tramadeezy said:
I love how she announces that she “aspirated first” prior to injecting. Totally oblivious to the safety disaster she was involved in.
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Your brain is like an iPhone with 10 windows open?

Steve Jobs has issues with this
 
I can't watch this. Thank you for describing it so I don't have to >_<
 
The kicker is at 8:43 when she looks over at the camera while the chiropractor is talking as if “man.. this guy is smart!” lmao.
 
Someone in California please report this, even if nothing happens. I agree with Steve-- report to Nursing Board, Med board, Chiro board. The potential future patients, er victims, will be thankful.
 
SGB are already a risky procedure. This NP doing it? Cool. I feel bad for the inevitable patient that shows up and it goes wrong. It will happen, mark my words.
 
Also - LOL @ "She is board- certified as an Adult-Gerontology Acute Care Nurse Practitioner." Why are NPs so obsessed with lengthening their title with word salad? Honestly, this place ought to be reported.
 
it would be difficult to have two people do a procedure together like that. two brains need to know what the other is thinking... notice he grabs the syringe and points it to the right trajectory. she's only there to push the plunger since his license doesn't allow for performing procedures.

when i watch videos like this it tells me that I am way overboard in my prep. mask? surgical gloves? probe cover? sterile technique? monitoring? baaah! just spin and shine and go with it! saliva is bacteriacidal, and much cheaper than chloraprep.

he's actually a skilled sonographer. i have never met him but know of him.

I would have started 2cm more medial and gone for underneath the CA as opposed to dropping big blob of medication that clumps there vs running down the fascia. does that look like a 10 ml syringe? you can get a good block here with US with 5 ml of injectate.
 
Can somebody explain to me how chiropractors (or RMSKs) are doing nerve hydrodissections, bone marrow concentrate injections, and stellate ganglion blocks?

Dr. Shawn P Tierney, DC, RMSK, Ultrasound

Dr. Shawn P Tierney, DC, RMSK​

Dr. Shawn P. Tierney is a musculoskeletal sonologist and leader of multiple regenerative medicine clinics in Southern California, specializing in ultrasound-guided procedures such as stem cells, PRP, spinal injections and nerve hydrodissection. Shawn Tierney, DC, RMSK, is an expert educator for physicians and sonographers in musculoskeletal ultrasound and serves as a faculty member of MSKUS. Dr. Tierney has done extensive work in Sports Medicine, Rehabilitation and Nutrition in addition to practicing Chiropractic Medicine for over 15 years.

Dr. Tierney received his degree from the Los Angeles College of Chiropractic Medicine. Prior to studying chiropractic medicine, Dr. Tierney was an environmental organic chemist and a personal trainer since 1986.

Not only does Dr. Tierney have experience as a nationally ranked body builder, he also actively assists in the recovery of many professional athletes. Dr. Tierney has treated members of the U.S. Water Polo Team, the U.S. Olympic Swim Team and professional athletes from the MLB and NFL.
 
Yes I also noticed that he took control of the needle from the NP when she let go. I am not sure that even moving the needle to the appropriate position is within his scope of practice regardless of whether he pushed the plunger or not.
 
I would imagine the supervising doc on their website is responsible for everything?
 
This is a stunning display of medicine 2020.

...I done recapped a billion needles...
 
oreosandsake said:
it would be difficult to have two people do a procedure together like that. two brains need to know what the other is thinking... notice he grabs the syringe and points it to the right trajectory. she's only there to push the plunger since his license doesn't allow for performing procedures.

when i watch videos like this it tells me that I am way overboard in my prep. mask? surgical gloves? probe cover? sterile technique? monitoring? baaah! just spin and shine and go with it! saliva is bacteriacidal, and much cheaper than chloraprep.

he's actually a skilled sonographer. i have never met him but know of him.

I would have started 2cm more medial and gone for underneath the CA as opposed to dropping big blob of medication that clumps there vs running down the fascia. does that look like a 10 ml syringe? you can get a good block here with US with 5 ml of injectate.
Click to expand...
Slow down...
Who said there are two brains here?
 
Heard the one company or the major distributor of sarapin got shut down.
 
Ligament said:
Can somebody explain to me how chiropractors (or RMSKs) are doing nerve hydrodissections, bone marrow concentrate injections, and stellate ganglion blocks?

Dr. Shawn P Tierney, DC, RMSK, Ultrasound

Dr. Shawn P Tierney, DC, RMSK​

Dr. Shawn P. Tierney is a musculoskeletal sonologist and leader of multiple regenerative medicine clinics in Southern California, specializing in ultrasound-guided procedures such as stem cells, PRP, spinal injections and nerve hydrodissection. Shawn Tierney, DC, RMSK, is an expert educator for physicians and sonographers in musculoskeletal ultrasound and serves as a faculty member of MSKUS. Dr. Tierney has done extensive work in Sports Medicine, Rehabilitation and Nutrition in addition to practicing Chiropractic Medicine for over 15 years.

Dr. Tierney received his degree from the Los Angeles College of Chiropractic Medicine. Prior to studying chiropractic medicine, Dr. Tierney was an environmental organic chemist and a personal trainer since 1986.

Not only does Dr. Tierney have experience as a nationally ranked body builder, he also actively assists in the recovery of many professional athletes. Dr. Tierney has treated members of the U.S. Water Polo Team, the U.S. Olympic Swim Team and professional athletes from the MLB and NFL.
Click to expand...
Rmsk i don’t understand who bothers with this still except for not doctors who need letters behind their names. It’s a written exam. Not sure what it really proves
 
dipriMAN said:
I can’t see the video, it’s private 🙁
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People had commented on it critically. Probably got scared and took it down. Their YouTube channel has her doing multiple pitches for the block. So sketchy.
 
Ligament said:
Well, here is a naturopath doing an SGB. Why do we have board fellowships and board certifications again?

Click to expand...

Dr. Timmermans received his naturopathic medical degree from the Southwest College of Naturopathic Medicine in Tempe Arizona. He completed his residency in integrative pain management and regenerative medicine at the Neil Riordan Center for Regenerative Medicine at SCNM in Tempe, Arizona. During his residency, he received advanced training in image-guided regenerative injections including prolotherapy, platelet-rich plasma, nerve hydrodissection, and autologous stem cell therapy. During this time, Dr. Timmermans also sought out additional training in peptide therapy, bioidentical hormone replacement, and IV micronutrient therapy. As a naturopathic doctor, Dr. Timmermans’ approach to resolving chronic pain and disease focuses on finding and treating the root cause, assessing and treating the whole person, and helping the body heal itself.

Absolutely amazing how much false confidence one can gain through inadequate training. What "residency" trains ND's to do high risk procedures like stellate ganglion blocks? This is one of those scenarios where I am 100% confident the partitioner does not truly realize the risks he is taking doing this procedure. How is this even allowed by the medical board?

I believe there is a place on the IOF website to report questionable practices.
 
rexed said:
Dr. Timmermans received his naturopathic medical degree from the Southwest College of Naturopathic Medicine in Tempe Arizona.
Click to expand...
The ONLY useful thing I got from this thread is finally knowing what is underneath Hollywood Upstairs Medical College.
 
How. Has. Medicine. In. The. Great. United. States. Come. To. This? Sure, report to the BON (who probably doesnt even know what a stellate ganglion is, let alone what goes into doing the block). They wont do anything bc procedures like this fall under the PRACTICE OF MEDICINE- which is conveniently handled by the BOM. She has a license to practice Nursing only (which is clearly all she should be doing) So...end point: the nurse wont be reprimanded at all but the collaborating physician will instead. Except thats in california—arent NPs supposed to be “freed” from the burden of collaborative physicians (when does that go into effect)? I doubt the chiro-husband-doctor legitimately counts as her collaborator. And what board oversees chiropractors (and do they actually regulate or just sit by silently as their doctors screw around with patients’ lives -and$$).
 
Consigliere said:
The ONLY useful thing I got from this thread is finally knowing what is underneath Hollywood Upstairs Medical College.
Click to expand...
I'm sure an ND education curriculum is equivalent to an MD curriculum to allow an ND to practice medicine like this? How?? AZ must be lax on their governance of medicine?
 
The mid level monster. Created by physicians. Training a PA/NP to do your routine pre and postop care works well if you are a highly skilled surgeon and your mid level could never do what you do. However, if you’re a surgeon wannabe eventually your mid level will decide “ hey, I could do that” and next thing you know they are your competition. Insurance companies and hospitals love it. They don’t care about patient safety. Moral of the story: don’t have midlevels do “doctor work” even if you think you have better things to do. Eventually you won’t have better things to do because your mid level will do that also.
 
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