Article Text
Abstract
Background and aims Regional anaesthesia provides effective analgesia for many indications in the elective and trauma settings. Providing a service outside the operating theatre setting can be challenging. This project aimed to implement a reliable and safe service for out of theatre regional anaesthesia.
Methods In order to facilitate delivery of regional anaesthesia outside of theatres, we have developed a portable ‘Grab Bag’ for nerve blocks containing all peripheral nerve block equipment and a guideline for out-of-theatre block placement. we have also created a sticker to facilitate documentation and further analgesia prescription.
Results Regional anaesthesia is carried out either in the emergency department or admission wards using a portable ultrasound machine. a safe environment was ensured by the availability of a trained operating department practitioner (ODP), antiseptic precautions, an emergency box for management of local anaesthetic systemic toxicity and a portable monitor to provide continuous monitoring for 30 minutes after the block. Blocks have been performed over the last 6 months by on-call anaesthesia teams, regional fellows and consultants. Feedback for the equipment has been very positive. the initiative has resulted in an increase in the number of nerve blocks being performed for fracture hip patients on the wards and in the emergency department. It has also decreased the burden on trauma theatres. No critical incidents have been reported.
Conclusions Specific outreach nerve block equipment and documentation can assist in providing efficient and safe regional analgesia for trauma patients outside the theatre setting.