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AUDIT ON STERILITY WHEN PERFORMING ULTRASOUND GUIDED PERIPHERAL NERVE BLOCKS AT A TERTIARY HOSPITAL IN THE UK
ESRA Academy. myint n. Sep 8, 2016; 138246
Topic: Peripheral Nerve Blocks
Dr. nilar myint
Dr. nilar myint

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Abstract
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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.

Methods:

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

Results:

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.

Conclusions:

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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