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STOP BEFORE YOU BLOCK AND INJECTION PRESSURES - JUGAAD INNOVATION MEETS REGIONAL ANAESTHESIA
Author(s): ,
Johnstone, C.*
Affiliations:
Guy's Hospital- London, Anaesthesia, London, United Kingdom
,
Pawa, A.
Affiliations:
Guy's Hospital- London, Anaesthesia, London, United Kingdom
,
Onwochei , D.
Affiliations:
Guy's Hospital- London, Anaesthesia, London, United Kingdom
,
Vargulescu, R.
Affiliations:
Guy's Hospital- London, Anaesthesia, London, United Kingdom
Razavi, C.
Affiliations:
Stevenage Hospital- UK, Anaesthesia, London, United Kingdom
ESRA Academy. Johnstone C. Sep 13, 2017; 190854
Topic: Local anaesthesia
Dr. Craig Johnstone
Dr. Craig Johnstone

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Abstract
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Background and Aims:

Despite the “Stop Before You Block” (SBYB) campaign, wrong sided blocks continue to occur, with 27 wrong sided blocks recorded between April 2016 and February 2017 in the UK. We believe an audio cue at the time of needle insertion could decrease the likelihood of wrong sided blocks. We also believe that a method of measuring injection pressures could be incorporated into the same device. 

Methods:

We have developed, coded, built and tested an Arduino∞(™)-based device which is attached to a block needle. We have utilised open-source resources (in line with Jugaad principles) and coded the device to our requirements, to issue a final audio reminder to 'Stop Before You Block' at the crucial point of the procedure, as the needle touches the skin. We have also added an injection pressure measuring device within the same prototype. 

Results:

The device has undergone a first wave of testing with separate volunteers using the device on different areas of the body to simulate the block process. It was triggered in 100% of cases indicating a high degree of reliability. We have also calibrated the pressure sensor and reliably indicates injection pressures <15psi, 15-20psi and >20psi via a series of graded LEDs. 

Conclusions:

The addition of an inexpensive purpose-built device to prompt user application of the SBYB principles and measure injection pressures could improve the safety of peripheral nerve blocks. Further testing and refinement is needed to help standardise its use. We invite people to try the device. 

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