Microsoft word - procedure instruction form (2).docx

APPALACHIAN REHABILITATION PROFESSIONALS, PC INSTRUCTIONS FOR ESI, FACET BLOCKS AND SI JOINT INJECTIONS ____ EPIDURAL STEROID INJECTION is an injection of steroid placed inside the bony spinal canal, into the space surrounding the fluid-containing canal (the dural sac). This procedure is done in the Outpatient Surgery Area where x-ray can be used. You will have an intravenous needle (IV) inserted for this procedure. If you are pregnant or suspect you may be pregnant, please notify your doctor. You may have a slight warmness or tingling in the buttocks or legs for a short time after the procedure. The steroid works to reduce swelling around the nerve root, which may be the cause of your pain. It takes the steroid between 48-72 hours to take effect which means you could experience an increase in pan for a few days until the steroid takes effect. A series of 2-4 injections over several months may be necessary. ____ FACET BLOCK is an injection of steroid to a specific area of the spine called the facet. This procedure is done in the Outpatient Surgery Area where x-ray can be used. After the procedure, you will then be taken to a Same Day Surgery room for a short time for observation before going home. You will have an intravenous needle (IV) inserted for this procedure. If you are pregnant or suspect you may be pregnant, please notify your doctor. ____ SACROILIAC JOINT INJECTION is a procedure to place steroid and numbing medicine into the joint that connects the spine to the pelvis. X-ray will be used to ensure proper placement. The doctor will ask about your pain before, during and after the injection to help evaluate the effectiveness. After the initial numbing medicine wears off you may experience a temporary increase in pain until 24-48 hours after the procedure. ____ MAJOR JOINT, BURSA INJECTION is a procedure to place steroid and numbing medicine into a joint. X-ray will be used to ensure proper placement. The doctor will ask you about your pain before, during and after the injection to help evaluate the effectiveness. After the initial numbing medicine wears off you may experience a temporary increase in pain until 24-48 hours after the procedure. BEFORE THE PROCEDURE: DO NOT TAKE: 7 days prior - ASPIRIN OR MEDICATION CONTAINING ASPIRIN ALL NON-STEROIDAL ANTI-INFLAMMATORIES SUCH AS: PLEASE LET YOUR DOCTOR KNOW IF YOU ARE ON COUMADIN OR OTHER BLOOD THINNER. If you have questions about your medications, please ask your doctor or pharmacist. PROCEDURE DAY: Take your morning medication before coming to the hospital/outpatient center except those listed on previous page. Please bring your current medication in the bottles. You may eat a LIGHT BREAKFAST (Example: juice and toast, block coffee). NO MIL PRODUCTS. You may drink liquids until 2 hours prior to your procedure (water, tea, soft drinks, black coffee). If your procedure is scheduled in the afternoon, you may have a snack of toast or crackers late morning. If you have questions concerning the procedure or if you are unable to keep your appointment, please call 423-392-8100. You will check in at the registration office and then be directed to the Same Day Services Desk and then taken to your room. The nurse in charge of your care will have you change into a patient gown, take your blood pressure, attach you to a monitor and do an evaluation of your pain. You will be asked to fill out some papers and your present medications will be discussed. When this is completed, the doctor will be notified. You are not put to sleep for your procedure. AFTER THE PROCEDURE: 1. After the procedure is completed, the nurse may take your blood pressure frequently. A short time after the procedure, with your doctor’s approval, you will be discharged. YOU MUST HAVE SOMEONE TO DRIVE YOU HOME AFTER YOUR PROCEDURE. IF NO ONE IS WITH YOU TO DRIVE YOU HOME, THE DOCTOR WILL RESCHEDULE YOUR PROCEDURE FOR ANOTHER DAY. 2. Rest the remainder of the day. Sedentary activity only. The following day you may resume your normal activities (or the restrictions your physician had you on before the ESI). 3. Do not drive any vehicle the day of the procedure. You may have some slight weakness in your legs (medication effect), which could cause problems if you try to drive. 4. For problems/concerns Monday-Thursday 8am-4:30pm or Friday 8am-12n, call 423-392-8100. For urgent problems related to your procedure after office hours and/or weekends, please call 423-224-4000 and ask them to page the physician on call for Appalachian Rehabilitation.

Source: http://www.appalachianrehabilitation.com/forms/instructions-for-esi-facet-blocks-and-si-joint-injections.pdf