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Get the free Epidural Steroid Injection (ESI) Referral Worksheet

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Ambulatory Care Services pH. 3195268721 Fax. 3195262126Epidural Steroid Injection (ESI) Referral Worksheet Date: Ordering Provider: Patient Name: Date of Birth: Contact Phone Number: Please include
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How to fill out epidural steroid injection esi

01
To fill out an epidural steroid injection (ESI), follow these steps:
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Prepare the necessary materials, such as a syringe, local anesthetic, and the steroid medication.
03
Ensure that the patient is in a comfortable position, either lying on their stomach or sitting with their back bent.
04
Clean the injection site with an antiseptic solution to prevent infections.
05
Apply a local anesthetic to numb the injection site and reduce pain.
06
Insert the needle slowly and steadily into the epidural space under the guidance of fluoroscopy or ultrasound.
07
Confirm the correct needle placement by observing the spread of contrast dye or using nerve stimulation techniques.
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Once the needle is properly positioned, withdraw any excess fluid or air and attach the syringe containing the steroid medication.
09
Slowly inject the steroid medication into the epidural space.
10
Remove the needle carefully and apply a sterile bandage to the injection site.
11
Monitor the patient for any adverse reactions or complications after the procedure.
12
Always follow proper medical guidelines and consult a healthcare professional for accurate instructions specific to the patient's condition and requirements.

Who needs epidural steroid injection esi?

01
Epidural steroid injections (ESIs) are commonly recommended for individuals who experience chronic pain or inflammation in the back, neck, or limbs.
02
Specific conditions that may benefit from ESI include:
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- Herniated or bulging discs
04
- Spinal stenosis
05
- Degenerative disc disease
06
- Sciatica
07
- Radiculopathy
08
- Arthritis
09
However, the decision to undergo ESI should be made by a healthcare professional who evaluates the patient's medical history, symptoms, and response to other treatments. It is essential to consult with a qualified healthcare provider to determine if ESI is suitable for an individual's specific case.
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Epidural steroid injection (ESI) is a procedure used to treat pain and inflammation in the spine.
Healthcare providers or physicians who perform epidural steroid injections are required to file ESI.
ESI forms can be filled out online or through paper forms provided by the healthcare facility.
The purpose of ESI is to reduce pain and inflammation in the spine by delivering steroid medication directly to the affected area.
Information such as patient name, date of procedure, type of steroid medication used, and any complications must be reported on ESI forms.
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