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Abstract
Background and Aims Vertebral canal haematoma following obstetric regional anaesthesia, although rare, can lead to catastrophic and life changing neurological damage. Early detection is essential to limit avoidable harm. In 2020, guidelines published by the AAGBI/OAA(1) recommended all women recovering from neuraxial anaesthesia should be: 1. Able to straight-leg raise (SLR) four hours following the last epidural/spinal dose. 2. Informed of the four hour timescale. 3. Encouraged to alert staff if recovery from neuraxial anaesthesia is delayed. The aim of this project was to implement the Regional Anaesthetic Alert Bracelet (RA-AB) (2) to comply with UK national recommendations.
Methods An RA-AB was designed to empower the patient to inform the multidisciplinary team (MDT) if unable to SLR four hours following their last neuraxial dose (fig.1). Following a patient survey and pre-implementation MDT education (fig.2), the RA-AB was introduced in Worthing Hospital delivery suite in April 2023. Nationally, RA-AB has been successfully implemented in over 50 NHS Trusts.
Results Pre-wristband implementation questionnaires surveyed 18 patients undergoing neuraxial anaesthesia for elective caesarean section, with over a fifth (22%) answering they would not know who to contact should they have concerns regarding residual neurological symptoms. A further question revealed fifty percent of patients surveyed would appreciate further information regarding expected recovery and complications.
The regional anaesthetic alert bracelet
QR code linking to education resource
Conclusions Introduction of the RA-AB project has been a simple, cost-effective way of meeting AAGBI/OAA recommendations. It empowers patients in their recovery and educates staff on safe recovery from neuraxial anaesthesia. Future work will assess wristband compliance, patient satisfaction and identify any delayed neurological recovery.