Improve Patient and Staff safety with the EPD
CategoriesPatient Handling

Spinal Blocks Epidural Safety Trends

Epidurals and spinal blocks are types of anesthesia that reduce or eliminate a person’s pain sensation. Spinal anesthesia is gained popularity over time as it is deemed to be safer for patients than general anesthesia and has a lower mortality rate for expectant mothers. Although these two forms of spinal anesthesia are similar the difference is needle placement. For spinal blocks, the needle is placed into the dural sac that contains cerebrospinal fluid where an epidural is injected into the epidural space. Both can be used to treat severe pain in the lower regions of the body. An Epidural injection is often used relieve pain from labor contractions in pregnant women. Another key difference is the length of time that each shot will offer pain relief. A spinal block is a single shot that typically lasts a couple of hours where an epidural actually leaves a catheter inserted in the back to allow a continuous drip of medication and the pain relief can be extended to handle a longer period of time, like 10-18 hours of labor contractions.

Spinal Blocks and Epidural Trends in Healthcare

Looking at the data of spinal anesthesia trends in surgery centers and hospitals both physicians and patients are choosing spinal blocks due to the safety and rapid recovery time. Many total knee and total hip replacement surgeries are using spinal blocks for this very reason.  Surgeons want their patients up and moving post surgery to improve patient outcomes. In 2021 Penn Medicine published a news release addressing the myth that general anesthesia is more dangerous than a spinal block. They make the point that patient deaths, outcomes, and delirium occurring within 60 days post surgery is about equal in a study that included 1600 hip-fracture patients across north America.  Patients are often given the choice of anesthesia and it would appear that Penn’s press release is well intentioned to reduce patient fears. And they make a very good case to equalize the risk between both techniques. They note that the post surgery delirium experienced by patients receiving a block vs. general anesthesia was about equal, However, undergoing general anesthesia often requires intubation and can lead to other side effects. It’s clear that most surgeons are recommending spinal blocks for their total knees and hips to reduce risks and improve outcomes but patients will likely have a choice.

Epidural Positioning Device

Epidural Positioning Device (EPD), also known as the Epidural Chair, is a key development in Safe Patient Handling solutions that helps position patients safely and securely in the ideal position so that an epidural or spinal block can be administered safely.  The EPD is a simple and easy-to-use and positioning device that has gained popularity worldwide. The Epidural Positioning Device or Epidural Chair is a portable device that provides the caregiver or nurse with the help they need for accurate positioning of patients while avoiding the risk of injury associated with manually positioning the patient and holding them while the needle is inserted.  An epidural Positioning Device (EPD) is commonly used in the pre-op area or surgical suite to administer the spinal block.  It is now the standard of care in Labor and Delivery units where epidurals are performed all day long.

Advantages of Epidural Positioning Device

  • Supports up to 600lbs
  • Reduces risk of injury to nursing and technical staff
  • Used for Epidural’s, Spinal Blocks, and Thoracentesis
  • Improves patient comfort and patient satisfaction scores
  • Improved efficiency and throughput for busy departments
  • Portable and moves from room to room easily
  • Assembles in less than 5 minutes
  • Creates a safe standardized process to improve patient and staff safety
SPH Medical's EPD Improves Safety
CategoriesPatient Handling

Safety During Spinal Blocks and Epidurals

The use of the EPD for patient positioning during spinal blocks and other procedures

An epidural or spinal block offers patients an option to remain awake and alert while receiving pain relief. They can even help patients to get back on their feet faster after surgeries and other procedures. Some doctors use epidurals to help patients acquire relief from chronic pain as well. An experienced medical professional blocks nerves by introducing an anesthetic, steroid or other medication via straight injection or a small catheter into the lower back. Epidural pain relief is often used during back, hip and knee surgery and the delivery of a baby. Yet, epidurals can pose risks to both patients and medical personnel. Read on to learn more about these risks and how staff at hospitals and surgical facilities are introducing safety during spinal blocks with an epidural positioning device (EPD).

How Common Is Epidural Pain Relief?

According to a Stanford study published in 2018, 71% of 17 million women received some form of spine-based pain relief during childbirth between 2009 and 2014. The researchers pulled the data from birth certificate records.

In a more recent 2021 study, also by Stanford, researchers learned that approximately 2.8 million pregnant women receive epidurals every year during delivery. As noted by the Mayo Clinic, approximately 50% of women who give birth at a hospital in a labor and delivery unit request epidural pain relief.

What Sort of Patient Injuries Can Take Place?

Accidental nerve damage is one of the most common injuries. Patients who experience nerve damage after an epidural often lose feeling, movement and strength in spots or extremities. Patients can also experience allergic reactions to medication, blood clots and infections.

Additionally, Stanford researchers found during the 2021 study that approximately 28,000 women across the nation experience an accidental puncture of the spinal dura mater membrane yearly. They tracked a small sample of women from the point of delivery up to 12 months and found that 74% of the new mothers experienced excruciating, debilitating headaches, known as post dural puncture headaches (PDPH), two months after delivery. By comparison, only 38% of mothers who didn’t experience an unintentional puncture had headaches. By six months, 52% of the first group still had headaches.

Of course, this type of injury and resulting headaches can happen to any patient who receives an epidural, including those who receive treatment through a surgery department. Other symptoms associated with PDPH include dizziness, nausea, vomiting, tinnitus, vision disturbances, lower pack or neck pain and physical stiffness.

What Risks Do Medical Personnel Face?

Anesthesiologists, nurses, operating room technicians and others must physically move patients into and out of position for an epidural. This type of movement often requires that they support a patient’s full weight with their bodies. They risk muscle and tissue strains and tears and back injury from attempting to lift too much weight or catching a falling patient. If a patient loses balance, they risk falling with the patient and injuries associated with falls. They must also maintain patients in a particular seated position during the procedure, which can put strain on their arms and back.

How Does an Epidural Positioning Device Provide Safety During Spinal Blocks?

An epidural positioning device, such as an epidural chair, makes it easier for staff in a surgery department or labor and delivery unit to perform safety during spinal blocks. Although called an epidural chair, the EPD is actually a portable tool that the nurse or technician places in front of the bed or table where the patient sits during the procedure.

They can position the patient with optimal cervical, thoracic and lumbar spinal flexion. This means that the patient leans forward with a flexed spine while seated, which is the best position for a professional to perform the needle insertion to reduce the chance of an error. Instead of the nurse or technician holding the patient in the right position, the patient maintains the correct position by leaning against supports.

Sources:

Stanford Medicine; Epidurals increase in popularity; Tracie White; June 26, 2018

Stanford Medicine; Post-epidural headaches can be more serious than previously known; Tracie White; August 2, 2021

https://my.clevelandclinic.org/health/treatments/21896-epidural
Epidural: What It Is, Procedure, Risks & Side Effects; Cleveland Clinic medical professional; 10/14/2021

CategoriesPatient Handling

Improve Safety During Spinal Blocks

According to MedlinePlus, a trusted online resource for up-to-date information related to diseases and a host of wellness issues, a spinal block is commonly prescribed to patients undergoing genital, urinary tract, or other lower body medical procedures. They are also prescribed to pregnant women, in addition to epidural anesthesia, before they are due to give birth in a hospital’s labor and delivery unit. Also known as spinal anesthesia, a spinal block is a type of neuraxial regional anesthesia that involves injecting a local anesthetic or opioid directly into the subarachnoid space to block pain signals that would otherwise travel to the brain. Spinal blocks do a terrific job of keeping pain at bay so that patients can get through a needed medical procedure. But they can sometimes pose a danger to patients and medical teams alike. Improving safety during spinal blocks can be done with an epidural chair or epidural positioning device.

Safety During Spinal Blocks: The Dangers They Pose to Patients and Medical Teams Alike

Studies show that spinal blocks can increase a patient’s chances of experiencing low blood pressure, meningitis or abscess, hematomas, difficulty urinating, seizures, and headaches. As far as medical teams are concerned, many suffer musculoskeletal injuries due to lifting, repositioning, or catching falling patients that have received spinal blocks. Most of these injuries involve back pain and back strain that is so severe that many say they can’t work for a few days following their injury. To further put this into perspective, in 2016, the 8,730 days-away-from-work cases filed by hospitals involved medical teams that suffered musculoskeletal injuries while tending to patients in a hospital’s surgery department or labor and delivery unit. An epidural positioning device (EPD), such as an epidural chair, could have helped medical teams in these hospitals avoid many of these injuries, as well as improve safety during spinal blocks and epidurals.

How an Epidural Chair Can Help Improve Hospital Safety

Manually positioning or moving patients from one location to another is the leading cause of injuries among nurses, operating room technicians, and anesthesiologists involved in treating the roughly 324,000 patients who receive spinal blocks each year. These injuries have motivated many hospitals to invest heavily in medical assistive devices to improve patient handling and lower the rate of injuries among hospital workers. One such device is the epidural chair. Also known as an epidural positioning device or an EPD, epidural chairs support the arms, head, chest, and feet of patients receiving spinal blocks. The support they provide minimizes the risk of falls and makes it much easier to transport patients from one location to another as needed for their medical treatments. Studies show that hospitals that use epidural chairs file fewer day-away-from-work cases than those that do not.

Conclusion

Whether we are discussing safety in a hospital’s surgery department or its labor and delivery unit, EPDs should be part of that discussion. And this is because they make epidural pain relief via spinal blocks easier and markedly safer for everyone involved.

The SPH Medical EPD improves safety for Spinal positioning
CategoriesPatient Handling

Using an EPD for Patient Positioning During Spinal Blocks

Most medical professionals who take part in orthopedic surgery say an epidural positioning device (EPD) significantly improves safety and comfort for patients getting a subarachnoid block and then undergoing orthopedic surgery. To better understand why they feel this way, it helps to know a little more about subarachnoid blocks and the type of orthopedic surgeries in which they are most beneficial. Using the epidural positioning chair for patient positioning during spinal blocks helps the nursing staff as well as the patient.

Why an Epidural Positioning Device Might Be Necessary Before and Even After a Subarachnoid Block

So that everyone is on the same page, a subarachnoid block, also known as a spinal block, is a general anesthesia alternative capable of producing an intense sensory, motor, and sympathetic blockade that keeps pain at bay.  The process entails injecting an anesthetic or opioid directly into the subarachnoid space via a fine needle.  These injections go into the patient’s back and leave them feeling numb from the waist down, making them ideal for orthopedic surgery involving the legs, hips, knees, and ankles.  The effects of a subarachnoid block can last from 2 to 4 hours.  That said, problems can arise when patients are left numb from the waist down after receiving a subarachnoid block injection.  To minimize the risk of patients falling when they have to transition from one location to another, medical staff will have to manually hold and support them, which requires a reasonable degree of counter pressure.  But even still, falls do happen.  And sometimes, both the patient and medical personnel end up suffering injuries as a result.

The Dangers in Patient Positioning During Spinal Blocks

According to a study published by the National Institutes of Health, the subarachnoid block or spinal block is the most widely practiced anesthesia technique used in surgeries involving the lower extremities, including orthopedic surgeries. In 2017, around 22 million Americans underwent orthopedic surgery of some kind. By the end of 2022, a projected 28 million will have undergone orthopedic surgery, according to a Globe Newswire study. Some of the nurses and anesthesia technicians involved in these surgeries either already have or eventually will suffer injuries due to not using an EPD, with falls, back strain, or both being to blame for the vast majority of them.

How Does the EPD Help for Patient Positioning During Spinal Blocks and Surgical Procedures?

First and foremost, EPDs are not limited to nurses and anesthesia technicians in a surgery department alone.  They can come in handy during post-surgery when patients are still in pain or find it difficult to move certain limbs.  Even in a surgery department, nurses and anesthesia technicians use them for non-orthopedic surgeries.  It is not uncommon to see them used before and after most surgeries involving a patient’s lower extremities.  EPDs can also come in handy in a labor and delivery unit to help move women from one location to another after childbirth, especially if they received epidural pain relief beforehand.  Whether in a surgery department, labor and delivery unit, or elsewhere in a medical setting, all EPDs work more or less the same.  They allow medical staff to position patients correctly and comfortably to facilitate cervical, thoracic and lumbar flexion.

To that end, the benefits of EPD, also known as an epidural chair, are as follows:

  • Can accommodate various patient body types
  • Can support patients weighing up to 600 lbs
  • Keeps patients who are dizzy or otherwise uncoordinated due to an epidural from falling
  • Allows nurses and other medical staff members time to tend to more pressing tasks

Bottom Line

Helping a patient get into a new position, especially when epidural pain relief is involved, can be challenging and dangerous.  Using EPDs or epidural chairs can make life easier, not to mention safer, for everyone involved.

The EPD improves nursing and patient safety
CategoriesPatient Handling

Staff Safety During Epidurals and Spinal Blocks

No Room for Error When It Comes To Staff Safety

It’s hard to imagine health care without anesthesia or analgesia. Even after 175 years, they’re a medical marvel that no one takes for granted. Technology and innovation may evolve at lightning speed, but there are still no shortcuts during epidurals and spinal blocks. Whenever anesthetists place a needle in a patient, they summon all their knowledge, training, skill, experience and powers of concentration. Where the spinal cord and nerve roots are concerned, there’s no room for error. Simply put, if epidural placement is inaccurate, pain is the least of anyone’s worries.

Positioning the Patient: What’s the Problem?

There’s more to getting pain medicine to the right place than most people realize. Before the needle can be positioned, the patient must be positioned. That’s almost always easier said than done, especially when the patient is elderly or feeble, has difficulty following instructions, or outweighs the assisting nurse. That last scenario is quite common and highly problematic.

In 2016, according to the U.S. Bureau of Labor Statistics, nurses were injured on the job at a significantly higher rate than full-time workers in other occupations. Fifty-one percent of injuries involved muscle strains, sprains or tears, and more than a fourth of those were back-related. The average recovery time away from work was seven days.

Work-related MSDs, or musculoskeletal disorders, are injuries caused by lifting or overexertion. In 2016, MSDs accounted for a whopping 44 percent of RNs’ occupational injuries.

Needless to say, if nurses go down, the whole system goes down. Maybe you’ve never given or received epidurals and spinal blocks. If not, you’re probably thinking, “How hard can it be to tell a patient how to sit?”

Well, it’s a little like telling a ballerina to hold a picture-perfect arabesque while the photographer tries different angles.

That’s an extreme example, but the point is this: Patients are asked to assume an unnatural position and sustain it throughout a tricky procedure that can’t be rushed. Incredibly, some rather primitive methods are still employed.

The Perils of Manual Positioning

To achieve the ideal position, it’s not uncommon for staff members to prop up patients on rickety bedside tables and unwieldy pillows. Nurses and anesthesiologists who lack state-of-the-art equipment must be resourceful.

With any luck, the bedside table won’t collapse or tip. Hopefully, the pillows won’t slip to the floor with the patient close behind. Women receiving epidurals before hard labor, even those who avoid injury, are in no mood for such nonsense. The assisting staff member could easily become the next patient.

Given all the things that could go wrong with manual positioning, it’s easy to see why EPD use is becoming more widespread.

The Epidural Positioning Device

For epidurals and spinal blocks it is necessary, the EPD (epidural positioning device) is a godsend. The design takes several things into account:

  • Ease and accuracy of epidural placement.
  • Patient stability and comfort.
  • Weight support up to 600 pounds.
  • Portability.
  • Staff safety.

The epidural positioner is not just a luxury item any more than a seat belt is a nice accessory for a car. EPDs make it easier for anesthesiologists to do their job. EPDs keep nurses healthy and on top of their game. EPDs help patients receive first-rate care with optimal outcomes. Given all those benefits and more, EPDs are increasingly considered necessary.

The Epidural Positioner in Thoracentesis

EDPs are widely used in labor and delivery, surgery and orthopedics. They are even useful in radiology departments.

Thoracentesis, also known as pleural tap, is a procedure to remove excess fluid in the lungs. A little fluid is appropriate for lubrication; it keeps the membranes involved in breathing from rubbing together. However, too much fluid interferes with lung capacity. Labored breathing and pain result. Excess fluid can also interfere with imaging or diagnosing disease.

In any case, thoracentesis also requires careful patient positioning and needle placement. During Thoracentesis patients must be supported in a comfortable position over a prolonged period while drainage occurs. Radiologists and their imaging teams are thankful for the EPDs that make their jobs easier and prevent injuries.

The uses and benefits of the epidural positioner become more apparent all the time. This is one innovation that will be around for a while.

https://www.bls.gov/opub/mlr/2018/article/occupational-injuries-and-illnesses-among-registered-nurses.htm

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