On the topic of anticoagulation...

[pmrmd]

But when you hold it and he dies from MI you are in court and add extra zeroes.

which is worse?
Which is more likely?

There wouldn’t be a judgment. The societal SOC is to hold anti-coagulation. Patient signs consent aware of risks, physicians say the standard was met and any case goes away.

Now I’m with you and do all TFs on Plavix, warfarin, Eliquis whatever and nothing is going to happen, but I don’t fault anyone for holding and could state that is still SOC.


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[lobelsteve]

For those lurking: I have worked for plaintiffs on cases of MI and CVA.
You want a hematoma rather than a corpse when showing up in court as a defendant.

 

[clubdeac]

That's it, I'm no longer accepting patients on AC. Too much risk either way

 

[painfree23]

But when you hold it and he dies from MI you are in court and add extra zeroes.

which is worse?
Which is more likely?

i mean you ask cardiology for a reason.
The ASRA guidelines still state to hold anticoagulation, don’t they?

 

[lobelsteve]

i mean you ask cardiology for a reason.
The ASRA guidelines still state to hold anticoagulation, don’t they?

for scs, kypho.
asra guidelines based on expert opinion not on data. They are killing and hurting people. Hence sis data.

 

[Ducttape]

just to be clear, nowhere in the literature is this regarding ILESI.

the article looks and makes conclusions about MBB and RFA, and suggests considering TFESI.

 

[lobelsteve]

Ceasing Anticoagulants for Interventional Pain Procedures

A troublesome issue in the practice of interventional pain medicine has been how to manage patients who need to undergo an invasive procedure but who are t

academic.oup.com

 

[Ferrismonk]

I'm changing employment to a new group, but this group tends to old-school stop anticoagulation for lots of simple procedures. Can any of you give links to cases where people have had a negative outcome because anticoagulants were stopped unnecessarily? I would like more than guidelines to show them and move to change the current practice.

 

[lobelsteve]

I'm changing employment to a new group, but this group tends to old-school stop anticoagulation for lots of simple procedures. Can any of you give links to cases where people have had a negative outcome because anticoagulants were stopped unnecessarily? I would like more than guidelines to show them and move to change the current practice.

Happy to testify against them. Last case I worked for this was in Chicago. Might be able to share some info privately.

 

[SSdoc33]

I'm changing employment to a new group, but this group tends to old-school stop anticoagulation for lots of simple procedures. Can any of you give links to cases where people have had a negative outcome because anticoagulants were stopped unnecessarily? I would like more than guidelines to show them and move to change the current practice.

you dont need a culture change. let the old docs practice how they want, you just do what you see fit. i doubt you are going to change any minds. i could post all day long how DJT is the worst thing since the black plague, but some would still love him. (i was making a point, not trying to turn this topic political)

 

[clubdeac]

you dont need a culture change. let the old docs practice how they want, you just do what you see fit. i doubt you are going to change any minds. i could post all day long how DJT is the worst thing since the black plague, but some would still love him. (i was making a point, not trying to turn this topic political)

Agree, that's what I do. The older "uneducated" guys who've never heard of painrounds hold everything for everything. I OTOH do my own thang

 

[callmeanesthesia]

Agree, that's what I do. The older "uneducated" guys who've never heard of painrounds hold everything for everything. I OTOH do my own thang

When I arrived at my new practice, my partner who’s been there for 14 years was holding everything for everything. I pretty quickly converted him to continuing for MBB/RFA just by showing him the ASRA guidelines and reassuring him that I did them on fully anti coagulated patients without issue. He’s still putting steroid in with his RFs though...

 

[painfree23]

When I arrived at my new practice, my partner who’s been there for 14 years was holding everything for everything. I pretty quickly converted him to continuing for MBB/RFA just by showing him the ASRA guidelines and reassuring him that I did them on fully anti coagulated patients without issue. He’s still putting steroid in with his RFs though...

Don’t hold ag for much other than ESIs or SCS. But I do put steroid in the RFs..