CE2 NSPM Phase 1 Base Knowledge and Lumbar Spine Intervention and Physical Assessment Course
Saturday January 15th 8:00-16:00
Sunday January 16th 8:00-12:00
Total of 12 CEUs for Course and up to 24 CEUs with NSPM Online CEUs
12 CEUs in Cadaver Lab and Hands-on Workshop
12 Online Course lectures
Online Material will be delivered by January 1 to your account. You will receive notification with the email you sign up with.
- Radiation Safety: Foundational principles of x-ray imaging and essential understanding of how to minimize clinical x-ray radiation exposure.
- Examine and discuss the foundational underpinnings of x-ray imaging from a technological perspective.
- Illustrate the recommended safe practices when working with clinical x-ray imaging
- Non-Surgical Pain Management (NSPM): What does it take to get started down the path?
- Illustrate the need for NSPM services and the rationale for CRNAs being uniquely poised to fill this service line skill set.
- Discuss imaging modalities utilized for the provision of NSPM Services with the goal of optimized patient safety and precise deposition of medication
- Discuss the pathway(s) currently available for CRNAs to obtain the didactic, hands-on training and long-term clinical practice mentoring requisite to provide safe NSPM interventions with quality outcomes.
- Physical Examination for Non-Surgical Pain Management: Focus on lumbar region and lower extremities
- Examine and discuss the common physical exam tests used to evaluate the lumbar region and lower extremities for dysfunction
- Discuss common normal and abnormal physical exam findings of the lumbar region and lower extremities.
- NSPM Sacroiliac (SI) Joint Considerations: Physical exam, evaluation and workup, imaging modalities and quality procedural intervention to optimize therapeutic outcomes
- Examine and discuss the physical exam considerations and evaluation criteria which leads to SI joint procedural interventions
- Describe the imaging modalities which provide reliable and quality information in the pre-procedural work up and in the provision of an SI joint injection.
- Setting up a Non-Surgical Pain Management (NSPM) Service: Considering infrastructure development, administrative support and quality service agreements.
- Describe the essential components to consider when developing a NSPM practice
- Examine and illustrate the current state of the value NSPM practice confers to the patient population, your professional referral colleagues and the facility where you practice.
- Current trends in steroid selection in NSPM practice
- Describe the pharmacological profile of common steroid used in NSPM practice
- Discuss the controversy related to non-particulate and particulate steroids in NPSM practice
- Introduction to MRI interpretation Part 1
- Describe and illustrate the basic physics of MRI, image optimization and modes/sequences to optimize imaging by anatomical region
- Define and recognize the normal anatomy in the lumbar, thoracic and cervical spines and compare to common types of pathology
- Discuss and differentiate between normal and abnormal MRI findings in the neuraxial region and how this correlates to patient presentation.
*** Recorded lectures, will have quizzes and credit attached over the next 6 months. Review for the course, intended for use as one develops NSPM Skills. (10 hours)
- Epidurogram Interpretation: Optimizing fluoroscopic imaging and understanding contrast media in the lumbar region of the epidural space.
- Examine the use and pharmacological properties of contrast media for fluoroscopic studies
- Illustrate and examine optimal, suboptimal epidurogram patterns in the lumbar epidural space.
- Lumbar Interlaminar epidural steroid Injection: Indications for use and optimal clinical utilization
- Examine the indications for use with lumbar Interlaminar approach to the lumbar epidural space.
- Illustrate epidurogram evaluation and clinical placement of Interlaminar epidural steroid injections.
- Lumbar Transforaminal Epidural Steroid Injection: Indications for use and optimal clinical utilization
- Examine the indications for use with lumbar transforaminal approach to the lumbar epidural space.
- Illustrate epidurogram evaluation and clinical placement of transforaminal epidural steroid injections.
- Lumbar Intra-Articular Facet Injection: Indications for LIAFI use and optimal clinical utilization
- Examine the indications for use with lumbar intra-articular facet injection
- Illustrate contrast media evaluation and clinical placement of lumbar intra-articular facet injection
- Lumbar Facet Diagnostic Medial Branch Block Testing: Indications for LMBB use and optimal clinical utilization.
- Examine the indications for use with lumbar diagnostic medial branch blocks in the lumbar region
- Illustrate optimal placement trajectory, contrast media evaluation and clinical placement of lumbar region diagnostic medial branch block placement.
- NSPM Nomenclature and Anatomy of the Lumbar Region
- Examine, discuss and illustrate the relevant anatomy and terminology used in NSPM practice specifically related to the lumbar spine.
- Critical Assessment of Physical Exam Findings: Differentiating between common findings, urgent referrals/treatments and emergencies which require team coordination.
- Examine and discuss potentially significant to critical assessment findings with NSPM patients.
- Illustrate common potential lumbar region intervention adverse events and managing these issues.
- Phase 1 Lumbar Region Putting it all Together: Case presentations focused on clinical decision making and outcomes from a retrospective view.
- Examine and discuss lumbar NSPM case based management and decision making
- Illustrate case based management of patients presenting with actual or potential lumbar spine pathology.
- Understanding the physiology and pathophysiology of pain, acute pain and chronic pain and understanding of the optimal individualized treatment pathways.
- Examine and discuss the physiology and pathophysiology of acute and chronic pain.
- Phase 1 Lumbar and NSPM Foundations: Terminology and Theory
- Examine and discuss the foundational concepts of NSPM
- Discuss the common terminology used in NSPM
Pre-Course Webinar (Planned for Sunday January 9th at 6pm)
***May change due to clinical schedule
- Phase 1 NSPM Pre-Workshop discussion, preparation for the cadaver Lab, physical exam and ultrasound stations. Question and answer session for the course.
- Examine and discuss the goals of the Phase 1 NSPM course
- Illustrate, discuss and ensure all participants are prepared for the workshop
Saturday January 15th 8-4 (8 CEs)
Arrive at 7:30 am
Meet Outside at assigned location by 7:30 am. Breakfast items served
The University of Arizona Tucson College of Nursing
1305 N Martin Ave
Tucson AZ 85721
8 CEUs Cadaver Lab, Ultrasound Scanning and Physical Exam
** Breakfast items and drinks provided. If you have special food needs, please plan accordingly
***WE have optimized the process on Saturday to increase opportunity for learning and maximize hands on time with Fluoroscopy, Ultrasound and Physical Exam. There will be 3 stations set up and groups will rotate through. Stations are listed below with objectives. Groups will be randomly assigned on arrival.
Cadaver Lab Station 1
- Understanding C-arm Safety and Nomenclature of C arm movement
- Optimal trajectory for Interlaminar Epidural Steroid Injections
- Optimal Trajectory for Transforaminal Epidural Steroid Injections
Hands on needle placement, Lumbar Interlaminar, Transforaminal Epidural Steroid Injection: Identification, Optimal Trajectory and Terminal Needle Placement. (2 CE)
Cadaver Lab Station 2
- Understanding C-arm manipulation for optimized needle trajectory
- Lumbar intra articular facet injections
- Lumbar facet medial branch blocks
Hands on needle placement, Lumbar Intra Articular Facet Injections and Medial Branch Block Testing: Identification, Optimal Trajectory and terminal needle placement. (2 CE)
Ultrasound Scanning for NSPM Procedures Station 3 (1.5 CEU)
- Foundational understanding of ultrasounds utility in NSPM practice
- Scanning for trochanteric bursal injections
- Scanning for trigger point injections
- Scanning for Piriformis injections
- Scanning for Ilioinguinal hypogastric nerve blocks
Illustrate, discuss and demonstrate hands-on ultrasound scanning of the pelvis and hip region.
Demonstrate knowledge of relevant anatomy through live scanning of the hip and pelvic region.
Advanced Physical Exam of Lower Extremities Station 4 (1.5 CEU)
- Discussion of the purpose of physical exam, relevant findings and utility within a NSPM practice
- Lower Extremity Reflexes and normal/abnormal response
- Lower Extremity Strength Testing and normal/abnormal response
- Evaluation for potential neuraxial pathology
- Documentation of physical exam findings
Examine, illustrate and discuss the physical examination of the low lumbar region and lower extremities for potential pathology
Demonstrate hands on physical exam of the lumbar spine, hips, knees and musculature
*** bring reflex hammer, we will practice on each other. shorts are recommended
12:00-12:30 (0.5 CE)
Working Lunch: What are the largest barriers to gaining NSPM skills… After you have gained administrative support.
Scott Rigdon CRNA MPH
Steve Martini MD
** Lunch items and drinks provided. If you have special food needs, please plan accordingly
3:30-4:00 (0.5 CE)
Open Session: Course conclusion with question and answer with instructors.
- Discuss the core concepts of the course, review cadaver lab, physical exam and ultrasound scanning.
Sunday January 16th, 2020
Arrive at 7:30 am
Meet Outside at assigned location by 7:30 am. Breakfast items served
The University of Arizona Tucson College of Nursing
1305 N Martin Ave
Tucson AZ 85721
8:00-12:00
Ultrasound Based NSPM Interventions
Cadaver Safety and Ultrasound Guided Procedures (1.0)
- Discuss Cadaver Safety with US guided interventions
- Practice Cadaver based US needle driving
Ultrasound NSPM Interventions of the Shoulder (1.0)
- Illustrate the Sonoanatomy of the shoulder joint
- Perform needle driving and optimized trajectory practice using ultrasound for NSPM shoulder interventions
Ultrasound NSPM interventions of the Knee (1.0)
- Illustrate the Sonoanatomy of the knee joint
- Perform needle driving and optimized trajectory practice using ultrasound for NSPM knee interventions
Ultrasound NSPM interventions of the Hip (1.0)
- Illustrate the Sonoanatomy of the hip joint
- Perform needle driving and optimized trajectory practice using ultrasound for NSPM hip interventions
Course Conclusion
