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Theresa Bowling MD, Wesley Knauft MD, Nishant Shah MD, Sanja Sinha MD

The use of ultrasound-guided regional anesthesia (UGRA) has dramatically increased in recent years, facilitated by the widespread availability of small portable ultrasound machines with high-resolution imaging. Numerous studies have shown that UGRA is the most effective technique to achieve the central requirement for safe, successful regional anesthesia blocks—namely, ensuring the optimal distribution of local anesthetic around the target nerves and minimizing the risk for injury to surrounding structures. Drs. Bowling, Knauft, Shah, and Sinha describe the benefits, techniques, and challenges of implementing an UGRA protocol for anesthesiologists.

Axis Imaging News

Judy Padula, MSN, RN and Matthew Ostroff, ARNP

Establishing vascular access is one of the most commonly performed medical procedures and plays a central role in patient care. However, obtaining PIV access is difficult in about 35% of patients who present to the emergency department. Ultrasound-guided vascular access can help address this issue, but a hospital must first create a program to educate clinicians in leveraging POCUS for this procedure. Nurses Judy Padula and Matthew Ostroff outline five steps in establishing an ultrasound-guided vascular access program: Identify and satisfy unmet needs, locate the safest, most cost-effective catheter site with ultrasound, use ultrasound-guided PIVs as an alternative to high-risk central lines, recognize the vital role nurse leadership can play in implementing a successful vascular access program, and leverage the nurse/physician partnership to optimize patient care.

DOTMed HealthCareBusiness News

Philip Corvo, MD, MA, FACS

Dr. Philip Corvo serves as chairman of the Stanley J. Dudrick Department Surgery and Director of Surgical Critical Care at Saint Mary's Hospital, Trinity Health Of New England, located in Waterbury, Connecticut. He leads an innovative ERAS (Enhanced Recovery after Surgery) program which is helping reduce opioid use, speeding patient recovery and reducing costs. DOTMed interviewed Dr. Corvo about the program he leads, in which he discusses the financial impact of ERAS, how to establish an ERAS program, and patient success stories.

OR Today Magazine

Philip Corvo, MD, MA, FACS, and Wesley Knauft, MD

Enhanced Recovery After Surgery (ERAS) is a paradigm shift in perioperative care that can benefit both hospitals and their patients. In this article published in OR Today by Philip Corvo, MD, MA, FACS, and Wesley Knauft, MD, they share a case study about their experience at Saint Mary’s Hospital, Trinity Health Of New England, a 347-bed acute care community teaching hospital in Waterbury, Connecticut, regarding the clinical and financial benefits of an ERAS program that includes Ultrasound Guided Regional Anesthesia (UGRA). Since the October 2015 launch of their opioid-sparing ERAS program, there have been striking improvements in the safety and quality of care for patients undergoing colorectal surgery, along with substantial reductions in costs, complications, and opioid usage. Learn more about their specific results, including the millions of dollars saved and the quality measure achievements.

Trevor Bromley

One of the main reasons cited regarding physician burnout is the administrative burden and hassle factor of electronic health records. Regarding imaging services, current PACS workflow solutions have been designed for MRI or CT machines making it harder for physicians who use ultrasound at the point of care to document their services with ease. There is now a new system, SonoSite Synchronicity software, that was exclusively designed with ultrasound and point-of-care applications in mind. This new system addresses compliance, quality improvement, credentialing, revenue capture and reduced administrative burden. In Trevor Bromley's Dotmed article Fujifilm SonoSite executives share information about SonoSite Synchronicity.

OR Today

Davinder S. Ramsingh, MD

With the release on May 30, 2019 of the final report from the Federal government’s Pain Management Best Practices Inter-Agency Task Force, anesthesiologists need specific case studies on how to implement recommendations in their hospitals. This OR Today article, published by Davinder S. Ramsingh, MD, Director of Research and Perioperative Ultrasound at Loma Linda University Medical Center, Department of Anesthesiology, shares ten applications of point-of-care ultrasound, a modality mentioned in Perioperative Surgical Home (PSH) and Enhanced Recovery After Surgery (ERAS) clinical practice guidelines. The Task Force’s final report recommends to clinicians the use of multidisciplinary and multimodal approaches for perioperative pain control in selected patients at higher risk for opioid use disorder. Read Dr. Ramsingh’s article to learn more about how anesthesiologists and pain medicine specialties can incorporate point-of-care ultrasound with regional anesthesia or TEE, both potential elements of these multi-modality approaches.

Theresa Bowling, MD

Enhanced recovery pathways (ERPs) have been shown to reduce costs and improve outcomes in nearly all surgical specialties, including shortening length of stay (LOS) by 30% to 50%, with similar reductions in complications and decreased readmissions. Compared with traditional care, ERPs have resulted in a cost savings of $6,900 to $7,129 per patient. This evidence-based approach to standardizing care of the surgical patient with best practices often includes regional anesthesia techniques, including ultrasound-guided regional anesthesia (UGRA), that result in longer block durations, faster onset times, improved block success, and a reduced need for opioids. In this article from the March 2019 edition of by Dr. Theresa Bowling of Integrated Anesthesia Associates, Fairfield, CT, learn about the results for several UGRA blocks and how to integrate them into your practice.

Nidhi Nikhanj, MD

Obtaining vascular access is one of the most common procedures performed in U.S. hospitals, with more than 5 million central venous catheterizations (CVCs) performed annually (Feller-Klopman 2007). Nearly 80% of critical care patients undergo CVC (Gibbs; Murphy 2006) for administration of fluids, blood products, or vasoactive drugs; hemodynamic monitoring; hemodialysis or transvenous pacing during an inpatient stay (Sisson; Nagdev 2007). To learn how to reduce complications, such as central line associated blood stream infections, with placing a CVC and achieve the one-stick standard, please read the article by Dr. Nidhi Nikhanj from the March 2019 Issue of

Diku Mandavia, MD, FACEP, FRCPC, Chief Medical Officer at Fujifilm SonoSite

HealthCare Business News

While providers continue to adhere to safe, low-dose imaging protocols, we are also seeing a trend toward finding new care pathways that use ionizing-free modalities. For example, more clinicians are opting to use point-of-care ultrasound over CT to diagnose appendicitis in children because it’s safer and has a very high accuracy rate. Many pediatric emergency physicians are an ultrasound-first philosophy because it delivers a speedier diagnosis. It’s less costly, safer, painless, and because children typically have low body fat, it’s easy acquire very clear images with ultrasound. Read this article in the March 2019 edition of by Dr. Diku Mandavia, Chief Medical Officer, FUJIFILM SonoSite, Inc. to learn more about the future of pediatric imaging.

Becker's Hospital Review

Nishant Shah, MD

During the year 2030, the number of Total Knee Arthroplasty (TKA) surgeries in the U.S. is projected to surpass 1.28 million. A recent study suggests that outpatient TKA can provide a cost savings of approximately $8,527 per patient (as compared to the standard length of stay group). Outpatient TKA also provides faster recovery time and fewer required opioid prescriptions through the use of targeted ultrasound-guided nerve blocks. Dr. Nishant Shah heads the outpatient total joint replacement program at Midwest Anesthesia Partners. In this article, Dr. Shah explains the many benefits of using ultrasound-guided regional anesthesia to enhance ERAS protocols.