Pain Pump, Risk Assessment,,,,HELP !!

[mcmike55]

I can use some input on this one.

Our new Ortho Doc wants to use the Moog Pain Pump on shoulder cases. You know, the kind filled with Marcaine and drips in.

We used them years ago, (different type) and had no problems.

Doing a brief lit review, I see all types of complications.

As I see it, the problems are, the catheters are place intra-articular and they shouldn't be, the meds contained Epi (should not), and possibly they were in too long.

We've addressed our concerns with the company rep, and surgeon and feel that the problems are recognized and addressed, but those above us, do not.

They want a full risk assessment run before we put one in, and the surgeon is none too happy!

My questions,,,,,what's your P&P, and experience with pain pumps, and what actually triggers starting a risk assessment??

I mean, when you think about it, almost anything could warrant one, from a new suture on up.

Where do you draw the line.

Don't get me wrong, I'm all for pt safety and all, but there has to be a line somewhere.....isn't there?

Mike

[TakeTwoAspirin, MSN, RN, APRN]

Our facility is big on EBP and stopped using/allowing pain pumps on shoulders a long time ago. There is a lot of research out their on the problems that have been experienced with pumps in shoulder cases. We still use them every day on other surgeries, just not shoulders.

Although I get what you are saying about mindless stuff coming down from the top that affects the way we practice, I gotta say that in this case I think they are correct to use caution. There have been too many law suites on this for them not to proceed with caution.

[scrubcircrn]

we stopped using pain pumps too. We do blocks on most cases- shoulders and knees.

[lindaloo51]

We did use the Stryker pump until it was recalled. We didn't use them with articular surfaces because I think that the Marcaine destroys the joint surface. We only used them on total joints. It seems to me that there were a lot of law suits because of this. We now use blocks on most knees and shoulders.

[glb1960]

We use Ambit pumps for our pain control with very good success. Never in the joint, just nerves; femoral, interscalene, poplitial, axial... As far as assessments going overboard, lawyers will ensure that we will always be buried in excessive C.Y.A. nonsense.