PNBschool

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.

Ok, the Board Review System alone is worth a look. I remembered when I studied for my original boards one thing that mad...
06/07/2026

Ok, the Board Review System alone is worth a look. I remembered when I studied for my original boards one thing that made a huge impact was knocking out 4-5 questions when:

1. I was waiting for surgeons
2. I was shopping with my wife🙄(find a chair)
3. Right before bed
4. Between my kids bball games.
5. In the car when I wasn’t driving.

There used to be an old app that I used that was no longer available so I made one, it’s better, more questions, better organized etc.

Add in the quick reference pharmacology and coexisting disease cards and the 10 hours of CME/CE hours available (so far) and you won’t be disappointed. So easy to claim AMA PRA category I and Ancc nursing CE’s.

Want something for FREE? 16 of the most common anesthesia regional techniques. TAP, ISB, Femoral, PENG, LFCN, Re**us Sheath, Supraclavicular etc etc. labeled block videos, proper initial prove and needle placement. Everything you need for a quick review or to learn new!!

Be part of the PNBschool Anesthesia Platform. Provide feedback. Want to add a feature, tell us about it in the comments. We have much more planned and are working on the next huge update NOW!

06/06/2026

If you know you know…we have all seen it.

Download the PNBschool Anesthesia and Blocks Mobile App.

• 10 hours of CME
• Board Review System, and e make it easy
• 16 regional blocks for free
• 120+ pharmacology and coexisting disease cards

Link is in our Bio!

06/05/2026

Stop overcomplicating your PENG blocks.

The anatomy is usually consistent. The target is identifiable. The biggest mistakes I see are poor ultrasound anatomy recognition and not using enough volume to allow the injectate to spread where it needs to go.

Master the anatomy first. Everything else gets easier.

Download PNBschool free from the App Store or Google Play. Link in bio. It includes:
✅ 16 FREE regional anesthesia block modules
✅ Annotated ultrasound anatomy and labeled procedural videos
✅ Up to 10 AMA PRA Category 1 Credits™ and Nursing ANCC CE’s available annually through our CME program
✅ 1,500+ board review questions across 39 subject areas
✅ 120+ pharmacology and coexisting disease reference cards

Built by anesthesia providers, for anesthesia providers.

06/05/2026

I get asked all the time, “Why did you choose ropivacaine instead of bupivacaine?” (or vice versa).

The truth is both are excellent long-acting local anesthetics, but there are some important differences in duration, motor blockade, and safety profile that may influence your choice.

Duration is usually the deciding factor for me. If I want to get the absolute longest duration out of a block I grab the .5% Bupivacaine, throw some adjuncts of choice in and give an appropriate large volume.

Which one are you reaching for most often?

06/04/2026

Arterial lines can be frustrating.

We’ve all had those days. Just can’t thread the catheter or even hit the artery!

When that happens, I try to go back to the fundamentals.

The experienced clinicians aren’t successful because they never miss.

They’re successful because they consistently apply the basics.

What arterial line tip made the biggest difference in your practice?

06/03/2026

Finish your CME without leaving the couch. The PNBschool app walks you through it in four steps —

1. choose the $99/year plan,
2. review the modules,
3. pass a 50-question exam,
4. claim your certificate.

That’s up to 10 AMA PRA Category 1 Credits™, plus 1,500+ board review questions, all from your phone. Built for the busy anesthesia professional who’d rather knock out CME on a break than burn a weekend on it.

📲 Download PNBschool free on the App Store and Google Play — link in bio.

Most blocks called an “ACB” aren’t one.Femoral triangle = proximal, risks quad weakness. True adductor canal = distal, s...
06/03/2026

Most blocks called an “ACB” aren’t one.

Femoral triangle = proximal, risks quad weakness.
True adductor canal = distal, sensory-selective, spares strength.
The divider: where sartorius crosses adductor longus.

Two centimeters changes the block.

Which one are you doing? 👇

The PNBschool Anesthesia Mobile App — free on iOS & Android. Link in bio.

06/02/2026

What’s your favorite excuse for a missed IV? There are a lot of them!😂😂😂

Yes we have a mobile app. I built it for a few reasons:

1. So I could use it to pass my board recertification. It was a hassle to find an easy way to study for boards, so I built my own board review.

2. I always seemed to be a few CME hours short for recertification so check that box.

3. I have seen the benefits regional anesthesia techniques have on my patients, so I wanted to share. I believe we should all know how to deliver a great nerve block and incorporate that into our practice.

4. I hate web searching things I have forgotten over the years such as infusion rates for drugs I don’t use very often or so coexisting diseases I don’t manage often. So I included those.

Give it a try! Download it. Get the subscription. Get reimbursed by your department lol. Life is good 😊

06/02/2026

TAP Blocks failing? Re**us Sheath Blocks may be your answer!

One of the biggest misconceptions in abdominal wall analgesia is expecting a TAP block to cover the entire anterior abdominal wall.

TAP blocks work well for lateral abdominal wall analgesia, but coverage becomes less reliable as you move toward the midline and above approximately T9–T10.

That’s where the Re**us Sheath Block shines.

By depositing local anesthetic in the posterior re**us sheath, you can provide excellent somatic analgesia for midline incisions from the xiphoid down to the p***s. Even better, studies have shown that when the injection is performed more cephalad (subcostal), local anesthetic can track inferiorly within the re**us sheath, creating remarkably consistent coverage.

Volume matters.

This is a fascial plane block, and adequate spread within the posterior re**us sheath is critical for success.

When you combine a TAP block for the lateral abdominal wall with a Re**us Sheath Block for the midline, you can provide somatic coverage to almost the entire abdominal wall.

Just remember:

✅ TAP = lateral abdominal wall
✅ Re**us Sheath = midline abdominal wall
❌ Neither reliably treats visceral pain

Understanding the strengths and limitations of each block can dramatically improve your abdominal wall analgesia strategy.

What volume are you using for your Re**us Sheath Blocks?

The PNBschool Mobile App includes free regional anesthesia modules covering abdominal wall blocks, ultrasound anatomy, needle placement, and local anesthetic volume recommendations. Link in bio.

06/01/2026

Are You Using the Wrong Approach for Your Interscalene Block?

Not necessarily.

One reason some regionalists choose an out-of-plane or hybrid approach is to reduce needle travel through the middle scalene muscle, where the long thoracic nerve and dorsal scapular nerve are commonly found.

The concern?
Passing an in-plane needle through this area may increase the risk of contacting these nerves if they aren’t identified.

That’s why some clinicians prefer a steeper needle trajectory directed toward the brachial plexus.

That said, both techniques are acceptable when performed correctly.

Personally, I prefer an in-plane approach whenever possible. Why?

✅ Continuous needle visualization
✅ Better control of tip location
✅ Ability to identify and avoid nearby structures, including the long thoracic and dorsal scapular nerves

The “best” technique isn’t necessarily in-plane or out-of-plane.

It’s the one that allows you to:
• Consistently see your needle tip
• Safely avoid non-target structures
• Reliably deposit local anesthetic where it needs to go

The approach is a tool. Visualization is the goal.

📱 Did you know the PNBschool Mobile App includes free regional anesthesia modules covering interscalene, supraclavicular, femoral, adductor canal, PENG, IPACK, TAP, and more?

Free to download on the App Store and Google Play.

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18697 Bagley Road
Middleburg Heights, OH
44130

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