New guidelines have been published to increase the safety of regional anaesthesia.
The Safe Anaesthesia Liaison Group (SALG) and the Regional Anaesthesia UK (RA-UK) have published a new national Standardised Operating Procedure (SOP) to prevent wrong side block. The updated procedure, Prep, Stop, Block, enhances the message of ‘Stop Before You Block’ – the ‘stop’ moment should occur just before needle insertion.
‘Stop Before You Block’ was initially a campaign devised by SALG and RA-UK in 2011, which had significant success but was not being interpreted consistently across different healthcare settings. In 2018 the Healthcare Safety Investigation Branch (HSIB) investigated the causes of wrong side regional anaesthetic block and invited the Safe Anaesthesia Liaison Group (SALG) to formulate a standard, national policy. The resulting working party, led by SALG, included representation from the Royal College of Anaesthetists Simulation Working Group, RA-UK, the Faculty of Pain Medicine, and NHS Improvement recommended the new ‘Prep, Stop, Block.’ SOP.
Professor Jaideep Pandit, Chair of the ‘Stop before you block’ working party said: “We are pleased that the SOP will now be applied nationally with the ‘stop’ moment as a two-person step that happens only after preparation is complete and thus immediately before needle insertion. Ensuring this is applied in a consistent way across all Trusts makes patient care safer.”
Dr. Nat Haslam, Honorary Secretary for RA-UK, said: “This SOP should be used by all healthcare professionals, both blocker and assistant, when placing of peripheral nerve blocks. The full SOP, demonstration video and poster (including a QR code link) can be found at www.ra-uk.org/index.php/prep-stop-block. These materials should be used to form departmental Prep, Stop, Block training packages.”
