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B86 Prep stop block — adaptation of the new uk standard operating procedure in the form of a block box
  1. J Hockridge,
  2. M Coates and
  3. L Tully
  1. St Bartholomew’s Hospital, London, UK


Background and Aims In 2010 the ‘Stop Before You Block’ (SBYB) campaign was launched in the UK, aiming to prevent wrong sided regional anaesthetic blocks. Despite this, the incidence of wrong side blocks remains around 1 in 62501.

In 2019, incidents of wrong sided blocks at Barts Health NHS Trust prompted renewed focus on block safety. We subsequently added an additional innovative safety layer: keeping block needles in a separate ”block box”, only to be opened after SBYB was completed.This protocol led to increased SBYB checks, reduced delay between SBYB and needle insertion and increased engagement of the team.

In 2021, a new ‘Prep Stop Block (PSB)’ campaign was launched, to be adopted nationally and replace SBYB2. We adapted the PSB policy to utilise the ‘block box’ at St Bartholomew’s Hospital and audited the effectiveness of this new protocol.

Methods We audited the new protocol by means of a survey. This was accessed via a QR code on the boxes and completed following block performance.

Results In 100% of regional blocks audited (12), a SBYB check was completed prior to needle insertion. The median time to complete the checklist was 20 seconds. The median time between completing the check and needle insertion was 37.5 seconds. All anaesthetists and ODPs strongly agreed that they were confident in using the block boxes and that they improved patient safety.

Conclusions This demonstrates that the PSB protocol can be adapted to incorporate the ‘block box’, potentially increasing adherence to the policy and improved patient safety.

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