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Salisbury ultrasound workshop advances anesthesia delivery skills

Scott Redmond, SRNA cannulates a simulated vessel using ultrasound
By Steve Wilkins, Public Affairs Officer

VA anesthesia specialists from the Salisbury, Durham and Asheville VA medical centers recently participated in a course offering the latest in ultrasound guided peripheral nerve block techniques.

The technology reduces reliance on narcotics after surgery.   

The educational offering was made possible by a grant provided by the Salisbury Foundation for Education and Research. Nineteen anesthesia practitioners attended the training conference in Salisbury, N.C. to hone their skills in Ultrasound Guided Peripheral Nerve Blocks. 

The use of ultrasound in anesthesia enables specialists to visualize the internal structures and place medications precisely at the target site. This reduces the block time, increases the success rate while improving the margin of safety. 

According to Salisbury Chief of Anesthesia, Elizabeth Bell, M.D., Salisbury’s team of physicians and Certified Registered Nurse Anesthetists (CRNAs) have been using nerve blocks for several years.  “Our anesthesiologists are very well trained in regional anesthesia techniques.”  Bell is committed to the practice and has recruited anesthesiologists who are expert in regional anesthesia techniques. She added that they have been working with CRNAs one on one in nerve blocks for at least the past four years while she has been on staff. 

There has been steady growth over the last five years in the practice of nerve blocks in anesthesia delivery. Ultrasound guided techniques are quickly becoming an industry standard, based on results. According to Salisbury Chief CRNA, Jeffery Buchholz, “With ultrasound guided techniques, we can more safely identify anatomic structures and increase the success rates for the various regional anesthesia procedures.”  Buchholz says being able to see the area [using ultrasound] affords the opportunity to position the drug directly to the target nerve, to block impulses, improving block success rates.

The procedure represents a win for everyone.  It lowers the risks associated with regional anesthesia and reduces dependence on general anesthesia, which has been shown to depress the immune system, can cause grogginess, nausea, vomiting, or in extreme cases, respiratory arrest. The use of regional anesthesia is less stressful on the body. It reduces inflammation, provides greater comfort, and enables patients to recover sooner. 

Conference coordinator Stephen Carrier, CRNA says they hope to increase the number and frequency of the training conferences.  This course, presented by Twin Oaks Anesthesia, of Clearwater, Florida, totaled 19.5 hours of didactic and hands-on training, using live models. As a result of the training, we intend to accelerate our in-house training and mentoring program. Our objective is to become a center for regional anesthesia excellence.

Bell, feeling the workshop was a success, added that they, “devoted two days for intensive study and practice on techniques we have already been using in our operating rooms (OR).  She continued, saying some staff have had more experience than others, so the event enabled all practitioners to feel more confident in their skills. 

Bell and Carrier agree that training staff on-site is the most efficient and cost-effective way to learn state-of-the-art regional anesthesia skills. While the training costs could be an initially prohibitive factor for some organizations, adoption of the practice appears to bring significant cost savings overall, justifying it in the long run. As they did in Salisbury, health care facilities can pool their resources to enable their staff to obtain valuable training.

Bell firmly believes, “incorporating ultrasound-guided regional anesthesia techniques in our practice has enabled our department to provide the best possible care to Veterans.”