PNBschool

The leading Independent anesthesia education platform.

Focused on regional anesthesia, ultrasound-guided nerve blocks, pharmacology, perioperative medicine, board review, and CME education through a modern mobile-first learning platform.

11/10/2026

Can’t see your needle? Your needle might be the problem.

Inside the PNBschool Mobile app:
• FREE: Question of the Day, 16 regional block modules, spinal simulation
• 1,500+ board review questions
• Epidural and central line simulations
• 70+ pharmacology and 60+ coexisting disease modules
• Up to 10 hours of CME
Download on the App Store or Google Play. Link in bio.

• Echogenic needles have reflectors built into the shaft that send the beam back to the probe.
• Echogenic needle + a flat angle = your best needle view.
• Tip still hiding? A small amount of local shows you where the tip really is.

11/09/2026

Can you see the whale? That one sign tells you which block you’re actually doing.

Inside the PNBschool Mobile app:
• FREE: Question of the Day, 16 regional block modules, spinal simulation
• 1,500+ board review questions
• Epidural and central line simulations
• 70+ pharmacology and 60+ coexisting disease modules
• Up to 10 hours of CME
Download on the App Store or Google Play. Link in bio.

• Femoral triangle level: sartorius and adductor longus form the whale sign. Slide distal down the thigh and you are in the adductor canal.
• At the femoral triangle level the nerve to vastus medialis sits lateral. Block it separately.
• Saphenous lateral to the artery, then carry the local over the artery to the medial saphenous branch. Same in both blocks.
• Adductor canal 15-25 mL, femoral triangle 20-25 mL. Both work for TKA and ACL, and both pair with IPACK. No femoral nerve weakness in our experience.

11/08/2026

This axillary spread misses one nerve. Can you name it before you watch?

Inside the PNBschool Mobile app:
• FREE: Question of the Day, 16 regional block modules, spinal simulation
• 1,500+ board review questions
• Epidural and central line simulations
• 70+ pharmacology and 60+ coexisting disease modules
• Up to 10 hours of CME
Download on the App Store or Google Play. Link in bio.

• The musculocutaneous nerve leaves the sheath early. Look between biceps and coracobrachialis: dark center, bright border.
• Redirect the needle laterally toward it and let the local open the plane.
• Local surrounds the nerve. Now the block is complete.
• Miss it and the lateral forearm stays awake.

11/07/2026

Floppy epiglottis. Cords hidden. Is it you, or is it the blade? Each one wins at something different.

Inside the PNBschool Mobile app:
• FREE: Question of the Day, 16 regional block modules, spinal simulation
• 1,500+ board review questions
• Epidural and central line simulations
• 70+ pharmacology and 60+ coexisting disease modules
• Up to 10 hours of CME
Download on the App Store or Google Play. Link in bio.

• Macintosh: tip in the vallecula lifts the epiglottis indirectly. Roomy channel for the tube and great tongue control, but a floppy epiglottis can hide the cords.
• Miller: the straight tip goes under the epiglottis and lifts it directly. Best look at the cords. Go paraglossal to keep the tongue off the blade; less room for the tube.
• Reduced fl**ge: same curve and technique as a Mac, with the fl**ge removed beside the teeth. Far fewer blade-to-tooth contacts.
• The studies: full view of the cords in 78% with Miller vs 53% with Mac (Achen 2008, n=161). Mac and McCoy were easiest to intubate in a 500-patient, 5-blade trial (Arino 2003).
• Learn all three: curved to pass the tube, straight to see the cords, reduced fl**ge to spare the teeth.

11/06/2026

Haven’t placed an epidural in a while? Your first epidural shouldn’t be your first rep. Run one before your next case.

Inside the PNBschool Mobile app:
• FREE: Question of the Day, 16 regional block modules, spinal simulation
• 1,500+ board review questions
• Epidural and central line simulations
• 70+ pharmacology and 60+ coexisting disease modules
• Up to 10 hours of CME
Download on the App Store or Google Play. Link in bio.

• Guided mode: learn the sequence from setup to test dose, with tips and pitfalls at every step.
• Rehearsal mode: run it from memory. No hints, and mistakes get flagged.
• Debrief: see your numbers (LOR depth, catheter at skin) and exactly what you missed and how to fix it.

11/05/2026

Can you find the plexus before the countdown ends? Look for the cluster of grapes just lateral to the subclavian artery.

Inside the PNBschool Mobile app:
• FREE: Question of the Day, 16 regional block modules, spinal simulation
• 1,500+ board review questions
• Epidural and central line simulations
• 70+ pharmacology and 60+ coexisting disease modules
• Up to 10 hours of CME
Download on the App Store or Google Play. Link in bio.

• Know the neighbors first: subclavian artery, first rib, pleura. Find all three before the needle goes in.
• The plexus sits lateral to the artery, resting on the first rib.
• Needle in-plane, lateral to medial. Keep the shaft and the tip in view the whole time.
• Initial injection inside the plexus, then finish with local surrounding it. Best for elbow, forearm and hand surgery.

CRNA anesthesiologistassistant PNBschool

11/04/2026

Small vein, flattening every time you advance? It is usually not probe pressure. Watch the needle.

Inside the PNBschool Mobile app:
• FREE: Question of the Day, 16 regional block modules, spinal simulation
• 1,500+ board review questions
• Epidural and central line simulations
• 70+ pharmacology and 60+ coexisting disease modules
• Up to 10 hours of CME
Download on the App Store or Google Play. Link in bio.

• Start out of plane, find the vein, and keep a light hand on the probe.
• Vein flattening means the needle is pushing on the front wall. Short, controlled advance; center the tip and wait for flash.
• Rotate the probe in-plane with the needle. Tip slightly into the back wall? Adjust before you thread.
• Advance and slide the catheter off the needle.

Yes! Out of plan is fine too!

anesthesiologistassistant SRNA PNBschool

11/03/2026

QL block, but which one? If you can’t name your target on the screen, you can’t put local there.

Inside the PNBschool Mobile app:
• FREE: Question of the Day, 16 regional block modules, spinal simulation
• 1,500+ board review questions
• Epidural and central line simulations
• 70+ pharmacology and 60+ coexisting disease modules
• Up to 10 hours of CME
Download on the App Store or Google Play. Link in bio.

• QL1: lateral QL border, deep to the TA aponeurosis. Supine, easiest view.
• QL2: posterior, behind the QL. QL3: anterior, between the QL and psoas.
• My take (anecdotal): QL1 is easier supine; QL2/QL3 are harder in the average patient and often need the patient turned lateral, but felt more consistent.
• Head-to-head data comparing QL approaches are limited. Match the approach to the case.

Yes QL nomenclature has changed. Thank you. Still great video!

CRNA anesthesiologistassistant PNBschool

11/02/2026

The new central line, spinal & epidural simulations are in PNBschool, so you can practice every step before your next patient. You also get up to 10 hours of AMA PRA Category 1 Credit™ / ANCC CME and free modules. Your first simulation is free.

📲 Download free: search “PNBSchool” on the App Store or Google Play.

11/02/2026

Femoral triangle block covering only part of the knee? You may be hitting one target when there are three. Name all three before you inject.

Inside the PNBschool Mobile app:
• FREE: Question of the Day, 16 regional block modules, spinal simulation
• 1,500+ board review questions
• Epidural and central line simulations
• 70+ pharmacology and 60+ coexisting disease modules
• Up to 10 hours of CME
Download on the App Store or Google Play. Link in bio.

• Target 1: nerve to vastus medialis, lateral to the femoral artery.
• Target 2: saphenous nerve, right beside the artery.
• Target 3: carry the local over the artery to the medial saphenous branch.
• 20-25 mL total. Three targets, one block. Watch the spread reach each one.

Address

18697 Bagley Road
Middleburg Heights, OH
44130

Website

http://PNBschool.com/

Alerts

Be the first to know and let us send you an email when PNBschool posts news and promotions. Your email address will not be used for any other purpose, and you can unsubscribe at any time.