cost of epidural trays

[hcrypt]

which company do you order single shot epidural trays from and how much do you pay for a box of 10 trays?

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[lobelsteve]

I never understood trays.

I use the following on every procedure I do:

10cc syringe (#1-3)
5cc syringe (#1-2)
18G 1" #1
27G 1.25" #1
25G 3.5" (may leave off if caudal with catheter)
non-fenestrated drape
fenestrated drape
10 pack sterile 4x4's

I add a Tuohy, 6" extension catheter, 22G 6" all as needed.
No tray will be more cost effective for my needs.

I always use Hibiclens (or generic) for prep. Avoids iodine skin allergy and is much easier to clean up as it is clear. This is my only $$$pig.

My MA or nurse preps the trays and if I'm late to the table, they draw up my meds and get the fluoo as close as they can.

 

[PMR 4 MSK]

Hospital I go to uses trays and I end up throwing out half of what they give me, sometimes adding a few things. I've given them a list of what I use, but so far I'm apparently not worthy enough to get my own tray. I only do 2-3 cases/wk there.

At our ASC, we use individual supplies and I have a pull sheet for each procedure. We've had offers to make trays but I cannot believe it will save money - where there's a middleman, there's an extra charge.

 

[ampaphb]

Hospital I go to uses trays and I end up throwing out half of what they give me, sometimes adding a few things. I've given them a list of what I use, but so far I'm apparently not worthy enough to get my own tray. I only do 2-3 cases/wk there.

At our ASC, we use individual supplies and I have a pull sheet for each procedure. We've had offers to make trays but I cannot believe it will save money - where there's a middleman, there's an extra charge.

I don't believe their argument has ever been direct cost savings - it has almost always focused on high volume practices, where the vale of efficiency is included in the calculation. If trays allow you to do one to two additional procedures, or perhaps even allow you to decrease your staff by 1/2 FTE, it has more than covered the direct additional cost of the supplies.

 

[Tenesma]

i found a good tray for me that has everything i need and it costs about 6.15/tray (i purchase through a large hospital collaborative agreement with a reseller) --- the only thing that gets added to the tray are the spinal needles... so usually my supplies (without meds) come to about $10/procedure...

i didn't look a the cost of the individual items, but the time saving of being able to store kits, and then open them up at a moments notice is worth the price...

 

[lobelsteve]

If trays allow you to do one to two additional procedures, or perhaps even allow you to decrease your staff by 1/2 FTE, it has more than covered the direct additional cost of the supplies.

I'll ask my acquisition/supply folks to get me unit cost on every item needed for an TF-ESI. I will them time staff on time it takes to open the equipment and set up my Mayo.

I think we'll find that there is no possible scenario where a tray is allowing an extra procedure to be done.

 

[PMR 4 MSK]

i found a good tray for me that has everything i need and it costs about 6.15/tray (i purchase through a large hospital collaborative agreement with a reseller) --- the only thing that gets added to the tray are the spinal needles... so usually my supplies (without meds) come to about $10/procedure...

i didn't look a the cost of the individual items, but the time saving of being able to store kits, and then open them up at a moments notice is worth the price...

We're paying about $30/bottle for contrast alone. Does that $10 include contrast?

 

[Tenesma]

does not include meds (including contrast)...

 

[spinepain]

~ $6.00/ tray would be well worth it compared to the extra time, storage, cost, etc. of using all separate items.

Tenesma, can you tell us which reseller you use?

 

[Tenesma]

McKesson is one of them - the large hospital group renegotiates every few months - so it could be somebody else by now...

 

[Mister Mxyzptlk]

I'll ask my acquisition/supply folks to get me unit cost on every item needed for an TF-ESI. I will them time staff on time it takes to open the equipment and set up my Mayo.

I think we'll find that there is no possible scenario where a tray is allowing an extra procedure to be done.

The trouble with that is people tend to work differently when you observe them. In the last century, time and motion analysts (aka efficiency experts) were very popular, and it seemed that they paid off. Then someone did the equivalent of an RCT and showed that the improvements were mostly due to people knowing they were being watched.

And nurses have a "special" way of tilting outcomes the way they want them to be. If the trays decrease their perceived hassle in setting up you will see amazing results with trays. If they hate the trays the study will come out negative.

 

[Tenesma]

gorback speaks the truth...