Pre and postprocedure protocols?

[clubdeac]

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Curious on what everyone's thoughts were regarding the following pre and post procedure protocols:

Making everyone NPO 6 hrs before a procedure; is it necessary for everyone or just those receiving conscious sedation?

Requiring everyone to have a driver after the procedure; necessary for everyone or just conscious sedation?

Hooking everyone up to an EKG, pulse ox and BP; is the EKG necessary?

I had different attendings do different things in fellowship and now have to come up with my own protocols. Any advice would be great!!

 

[PMR 4 MSK]

Curious on what everyone's thoughts were regarding the following pre and post procedure protocols:

Making everyone NPO 6 hrs before a procedure; is it necessary for everyone or just those receiving conscious sedation?

Requiring everyone to have a driver after the procedure; necessary for everyone or just conscious sedation?

Hooking everyone up to an EKG, pulse ox and BP; is the EKG necessary?

I had different attendings do different things in fellowship and now have to come up with my own protocols. Any advice would be great!!

NPO - only for sedation. Locals it is unnecessary.

Driver - almost required, not 100%, maybe 99%, assuming local. We try to get everyone to bring one, but some will drive themselves anyway. sedation = 100%.

EKG not necessary.

One thing to think about is there is little magfical about a procedure being done under fluoro vs blind that makes extra precaution neccesary, except neuraxial. If you are doing blind ESI, you should still have BP, pulse ox at least quickly available. You don't use them for TPI in the clinic, so you probably don't need it for SIJI or other joints (besides facet) under fluoro.

BUT, if something goes wrong, and it is not available, what's the lawyer gonna be looking for? Always err on the side of safety. It's not much of a PITA to hook up BP and pulse ox, and the equiptment is not expensive.