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109 An audit of response times to epidural requests on a busy UK labour ward
  1. T Moody,
  2. A Qureshi and
  3. M Nejdlova
  1. University Hospital Birmingham, Birmingham, UK


Background and Aims Epidural analgesia is the gold standard for labour analgesia. Recently the availability and timing of an epidural has been topical in the UK news 3,4,5. The time from an anaesthetist being informed of epidural request to attendance should be less than 30 minutes; or 60 in exceptional circumstances. This single centre audit aims to assess anaesthetic attendance times according to the standards set by the OAA and AAGBI 1,2.

Methods We looked at all epidural requests over 3 months at a busy UK maternity unit. With each epidural, the time of request, the time of anaesthetist being informed and the time of attendance of anaesthetist were noted. Reasons for delays, including delays between the request and informing the anaesthetist were recorded.

Results 31 from 50 epidural requests had the anaesthetist attend within 30 minutes of being informed. The anaesthetist attended 37 times within 60 minutes of being informed.

Abstract 109 Table 1

The most common reasons for delay were unavailability of the anaesthetist, the anaesthetist not being informed, CTG concerns and awaiting blood results.

Abstract 109 Table 2

Conclusions Out of hours, one resident anaesthetist was on call with a non-resident consultant. If a case was on-going in theatre, this potentially delayed discussion for epidural. It highlights the need for additional resident labour ward anaesthetists at busy units in line with GPAS guidelines 1. In our unit we rolled out an educational program aimed at educating the multidisciplinary team on epidural provision and developed posters for the unit on the need to respond to epidural requests within 30 minutes.

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