Labs prior to spinal injections?

[oneforfighting]

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Does anyone order labs routinely prior to injections? Had a patient (works as RN) tell me she was surprised that I did not check platelets prior to her CESI. I don't routinely order them but if I did it would probably not be so much for MBBs but more for interlaminar CESI/LESI. Thoughts?

 

[SSdoc33]

no

 

[gaspasser127]

Does anyone order labs routinely prior to injections? Had a patient (works as RN) tell me she was surprised that I did not check platelets prior to her CESI. I don't routinely order them but if I did it would probably not be so much for MBBs but more for interlaminar CESI/LESI. Thoughts?

Not unless you had a reason to suspect they had low platelets or a coagulopathy (hepatic disease, history of easy bruising or bleeding, ITP, etc)

 

[Agast]

Is she a labor and delivery RN?

 

[runfastnow]

CVICUNICU RN

 

[bedrock]

RN=Just enough medical knowledge to be dangerous.

Similar to first year medical students.

 

[swamprat]

Negative

 

[Ferrismonk]

Not unless you had a reason to suspect they had low platelets or a coagulopathy (hepatic disease, history of easy bruising or bleeding, ITP, etc)

This is consistent with Anesthesia preoperative guidelines.

Is she a labor and delivery RN?

This is my guess. Pregnancy itself is a cause of low platelets and since we do a ton of neuraxial in pregnant ladies, everyone gets a CBC on admission.

 

[bedrock]

This is consistent with Anesthesia preoperative guidelines.


This is my guess. Pregnancy itself is a cause of low platelets and since we do a ton of neuraxial in pregnant ladies, everyone gets a CBC on admission.

Yep. And to an RN, who knows procedure protocols, (but doesn’t understand the science behind them) it seems a pain physician is “wrong/bad” not to order cbc before an ESI on an otherwise healthy individual.

 

[painfree23]

CVICUNICU RN

* RN, BSN, BS, BA, CNA, FNA, CAAP-ST

 

[Laryngospasm]

* RN, BSN, BS, BA, CNA, FNA, CAAP-ST

Ccrn, Ecmo certified, acls pals, msn, FOS

 

[gaspasser127]

Was the nurse/patient just curious or did she act like you were practicing recklessly?

 

[oneforfighting]

Is she a labor and delivery RN?

I think med/surg

 

[oneforfighting]

Was the nurse/patient just curious or did she act like you were practicing recklessly?

Just curious

 

[GlowInTheDark]

RN=Just enough medical knowledge to be dangerous.

Similar to first year medical students.

Med students will at least keep their mouth closed with the ridiculous medical opinions most the time.

 

[Agast]

Med students will at least keep their mouth closed with the ridiculous medical opinions most the time.

You know what, a patient has a right to ask these kinds of questions. No need to take it personally. This isn’t a nurse-doctor relationship when you’re consenting them for a procedure. I typically ask them if there was something in particular they were worried about so that I know how to phrase the answer.

 

[painfree23]

No, only for stims

 

[10KHertz]

Yes , Covid 19 test prior to asc or hospital procedures… 😝
Not sure when that will cease

 

[painfree23]

Yes , Covid 19 test prior to asc or hospital procedures… 😝
Not sure when that will cease

Seriously? Still doing it?

 

[10KHertz]

Seriously? Still doing it?

Yup. CDC policy is nebulous.
Surgical centers had dropped Covid testing for vaccinated patients for awhile , but back to pretesting.

 

[gaspasser127]

What a waste of personnel (already a shortage) and $$$

 

[10KHertz]

What a waste of personnel (already a shortage) and $$$

A few hospitals under investigation for excessive Covid testing, billing, and stealth deals with governor … dirty