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RE-SURVEY OF WRONG-SIDED NERVE BLOCKS IN THE UNITED KINGDOM
ESRA Academy. myint n. Sep 8, 2016; 138323
Topic: Safety of Regional Anaesthesia - Complications - General Aspects
Dr. nilar myint
Dr. nilar myint

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Abstract
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Background and Aims:

Inadvertent wrong-sided nerve blocks can have catastrophic consequences and may lead to wrong-site surgery. Despite the introduction of “Stop before you block” (SBYB) campaign in 2009, there are still cases of wrong-sided blocks being reported each year. We look for regional differences in the UK and compare with a 2011 survey.

Methods:

An online survey was emailed to all Schools of Anaesthesia registered with the Royal College of Anaesthetists.  Questions asked were their seniority; their frequency performing nerve blocks; experience with wrong-side block/near misses; their measures to prevent wrong-sided blocks; knowledge of local guidelines and what they thought would help prevent wrong-side blocks.  Responses were collected over March/April 2016.

Results:

Total of 175 responses from 39.8% Consultants and 30.7% Registrars.  Twenty-four percent had experienced wrong-sided blocks or near misses.  London was least aware of local guidelines on preventing wrong-sided blocks (52%) but reported the lowest incidence of wrong-sided blocks or near misses (14%). North West reported the highest uptake of SBYB (72%). Most commonly WHO checks with consent form was confirmed with an awake patient.

Conclusions:

Incidence of wrong-sided blocks has reduced in the NW from 30% in 2011 to 24% possibly due to increased uptake of SBYB (21% in 2011 to 72%). All regions agreed the best measures would be to double-check: confirm side of block with an awake patient, the surgical marking and consent form; and then again with an assistant immediately before needle insertion. We recommend all hospitals to have clear guidelines and anaesthetists to be aware of them.

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