Article Text
Abstract
Please confirm that an ethics committee approval has been applied for or granted: Not relevant
Background and Aims There is limited national guidance available on infection control measures for peripheral nerve blocks. We were aware of some variation in practice and conducted a survey to establish if local guidance should be developed.
Methods A survey was generated using Microsoft Forms and circulated around our department via email. Respondents indicated their standard practice for single shot peripheral nerve blocks. There were 4 questions covering use of gloves, probe coverings, skin disinfectant and gel. Each question had a range of preset answers. All responses were anonymised.
Results A total of 38 responses were received (54% response rate). Results are detailed in table 1 (preset answers without any responses were omitted). The majority of respondents use sterile gloves and probe covers (87%). The most commonly used skin disinfectant is 2% Chlorhexidine (76%). All respondents use individual sachets of gel rather than multidose dispensers.
Conclusions Higher concentration (2%) Chlorhexidine is non superior to lower concentration (0.5%) preparations at reducing risk of infection and has a higher theoretical risk of neurotoxicity. The 2% Chlorhexidine also has a greater financial and environmental cost due to its integrated single use applicator. Whilst there are limitations with self-reported data, the survey demonstrates a relatively consistent approach to other infection control measures amongst our department. The results of this survey have been shared with the department. Local guidance is being developed to promote use of 0.5% Chlorhexidine for peripheral nerve blocks. We plan to audit practice in due course. National guidance would be welcomed to help further standardise practice.