ESRA Academy. Myint N. Sep 8, 2016; 138246; 0064 Topic: Peripheral Nerve Blocks
Dr. Nilar Myint
Dr. Nilar Myint

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Background and Aims:

No guidelines are currently available on sterility precautions when performing ultrasound guided peripheral nerve blocks (UG PNB); established guidelines are available for central neuraxial blocks and nerve block catheters in the UK and USA.

The incidence of infection after a PNB is currently unknown but a case of severe infection after an axillary nerve block has been described. We conducted this survey to investigate practice in our department and to identify areas for improvement.


An online questionnaire via SurveyMonkey was distributed to all Anaesthetists in our hospital in September 2015.


Thirty-four responses were received from 22 Consultants, 11 Registrars and 1 CT1. Twenty-five (70%) routinely perform UG PNB. All use Chlorhexidine 2% as skin disinfectant, 24(96%) wear sterile gloves, 21(84%) use sterile gel, 20(80%) use Tegaderm as a probe cover, 20(80%) wear a theatre hat, 8(32%) use sterile ultrasound sheaths, 6(24%) use sterile drapes, 4(16%) wear facemasks and 1(4%) wears a gown. 
Only 3(12%) use a trolley when performing the block but 16(64%) use their glove packaging to lay their equipment on. Nineteen (76%) would value having a block trolley. Sixteen Anaesthetists (62%) recognised their sterility practice could be improved.


These results were presented at the Trust’s Audit meeting. Recommendations were made to routinely use sterile drapes, wear masks and use a procedure trolley. Dedicated trolleys are being introduced for all the sterile equipment needed to promote sterility. We will re-audit practice once the equipment is available and in use.

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