2 4 • O U T PA T I E N T S U R G E R Y M A G A Z I N E • N O V E M B E R 2 0 1 8
S
ame-day surgery is
vulnerable to the
risk factors of
wrong-site blocks, notably
time pressure to stay on
schedule, distraction, inade-
quate communication and
hard-to-see site marks.
Plus, in many facilities,
anesthesia providers care
for the same patients in the
OR on whom they placed
nerve blocks. Here are some tips from the Pennsylvania Patient Safety
Authority and Pennsylvania Society of Anesthesiologists' "Principles
for Reliable Performance of Correct-Site Nerve Blocks"
(osmag.net/c6VUyA). Like most safety measures, it starts in pre-op.
Pre-operative verification
Confirm patient identity using at least 2 forms of patient identi-
fication. Reconcile and verify the exact site and laterality of the surgi-
cal procedure and the nerve block site using all forms of available pri-
mary and confirmatory patient sources, including the surgical con-
sent, the patient (or relative), the OR schedule, and the history &
physical. If any sources differ, stop the process and alert the surgeon
to resolve the disagreement.
1
Tips to Avoid Wrong-Site Nerve Blocks
Regional anesthesia has its own set of safety principles.
Anesthesia Alert
Donald E. Martin, MD
• PRE-NERVE BLOCK TIME OUT During the block time-out, both the
anesthesia provider and the RN block team member should verify the pro-
cedure and its laterality that are documented on the surgical consent.