Patient question

[bedrock]

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I have a patient from a rural area with bad knees in early 50s. Failed one knee replacement, OA in other. Insurance doesn’t cover genicular RFA so I did hers for cash. She came with a driver last time and I had her take a Xanax and a Norco which helped her tolerate her bilateral genicular RFA.

She comes from a rural area 4 hrs away. This time she wants to drive herself, skip the pills, and drive herself home the same day. 10hr project.

She is asking if I think it’s ok to drive home 4 hrs after this procedure.

She is a normal person, not flaky. I guess I just worry about liability if she gets in an accident on the way home at the end of this 10 hr project?

 

[Agast]

No motor involvement and theoretically with the nerves numbed her knees will work better than they did on the way over. I think it’s fine without the sedating pills. Just as you can drive after shots into both knees.

 

[callmeanesthesia]

Personally I wouldn’t. But I use quite a lot of local for a genicular. Come to think of it, I don’t think I’ve ever had anyone with a weak foot after either though.

 

[lobelsteve]

My patients drive for all procedures.

 

[pastafan]

I would allow her to drive. If it is her left knee you are treating this time how could it possibly interfere with driving?

 

[Agast]

He said bilateral genicular

 

[Ducttape]

shared decision making.

discuss risks of driving after procedure and potential pain with procedure might affect her ability to drive. document, and let her make decision to drive or stay overnight at a local hotel.

then tell her to get a vehicle with self drive technology.

 

[painfree23]

My patients drive for all procedures.

Even ESIs?

 

[buddababa]

Even ESIs?

yup all

 

[SpineandWine]

SI is the only procedure I suggest either driver or potential person who could pick them up

 

[lobelsteve]

Even ESIs?

Even kypho and scs trials.

 

[clubdeac]

Even kypho and scs trials.

You let all procedure patients drive themselves home? Am I understanding you correctly. Seems you’re putting yourself at unnecessary medicolegal risk

 

[lobelsteve]

You let all procedure patients drive themselves home? Am I understanding you correctly. Seems you’re putting yourself at unnecessary medicolegal risk

Yes. And no.

 

[clubdeac]

Yes. And no.

Odd coming from the guy who’s ready to fry anyone in court for going against the standard of care.

I agree that most can probably drive safely themselves, especially when anesthetic is left out however, what happens when they get in a wreck and kill themselves and someone else. You really want to be brought into that lawsuit?

 

[lobelsteve]

Odd coming from the guy who’s ready to fry anyone in court for going against the standard of care.

I agree that most can probably drive safely themselves, especially when anesthetic is left out however, what happens when they get in a wreck and kill themselves and someone else. You really want any brought into that lawsuit

No local. No restrictions. How about mohs surgery? No driver. Flu shot? Knee injection.

 

[callmeanesthesia]

No local. No restrictions. How about mohs surgery? No driver. Flu shot? Knee injection.

MBB? RF?

 

[lobelsteve]

MBB? RF?

Everything in office means no driver required.

 

[paindoc007]

Stim trials don’t drive themselves home. Ever.

 

[Asclepius186]

I have let some lumbar MBB, RFA, and ESI (without local anesthetic in the shot) drive themselves. Only select patients I trust, and only after the examine them post procedure.

For most people, having a driver for a procedure is not a big burden. I’m not willing to risk a lawsuit from an MVC after letting someone drive home.

 

[DOctorJay]

my concern is also some lawyer convincing a bunch of uneducated jurors that an injection caused a patient's inability to step on the brake pedal hard enough and injure or kill someone.

 

[SSdoc33]

has anyone ever had a patient get into an accident after a procedure?

with all of our combined experience? ive never heard of it

 

[paindoc007]

has anyone ever had a patient get into an accident after a procedure?

with all of our combined experience? ive never heard of it

Who cares. Standard of care. Industry recs. Stim trials, regardless if it’s parasthesia or 10k, do not drive home.

 

[SSdoc33]

Who cares. Standard of care. Industry recs. Stim trials, regardless if it’s parasthesia or 10k, do not drive home.

i generally make patients have a ride, but where is it SOC? where is it written that it is an industry rec?

for stim trials or if there is conscious sedation, then of course they need a driver

 

[paindoc007]

i generally make patients have a ride, but where is it SOC? where is it written that it is an industry rec?

for stim trials or if there is conscious sedation, then of course they need a driver

I’m talking specifically for scs trials. Were in agreement here.

 

[RoloTomassi]

Driver only if sedated. Not sedated, any deficits should be apparent before they walk out.