A site check prior to regional anaesthesia to prevent wrong-sided blocks

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Slocombe, P
Pattullo, S
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2016
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Abstract

This paper describes the implementation of the 'Stop Before You Block' (SB4YB) initiative in an Australian teaching hospital. This process, which began in the UK in 2010, is a pre-procedure pause to confirm the correct side of a regional anaesthetic block. A change in practice was implemented with the formal roll out of a SB4YB educational program. Use of the initiative was then audited over a subsequent three-month period. It was hoped that after implementing the initiative, at least 80% of blocks would have a site check performed. However, despite apparent support for the initiative, uptake was less than expected with only about 57% of blocks having a site check performed. A site check was less frequent if the block was done as an emergency procedure, outside of an operating theatre or by a locum or visiting anaesthetist. Our conclusion from the audit was that education is insufficient to promote a change in this practice. We propose that Stop Before You Block or a block time-out should be performed prior to all unilateral nerve blocks. Success of this initiative requires education, and both cultural and systems changes to occur. We propose that a formal block time-out should become part of the surgical safety checklist and this activity should be endorsed and promoted by anaesthetic professional bodies.

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Anaesthesia and Intensive Care

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44

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4

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Biomedical and clinical sciences

anaesthesia

checklist

local

nerve block

patient care

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Slocombe, P; Pattullo, S, A site check prior to regional anaesthesia to prevent wrong-sided blocks, Anaesthesia and Intensive Care, 2016, 44 (4), pp. 513-516

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