Stop before you Block

The Queensland Health Stop before you Block project is an initiative of the Statewide Anaesthesia and Perioperative Care Clinical Network (SWAPNet).

Inadvertent wrong-sided peripheral nerve blocks are uncommon but can have serious consequences including complications from the unnecessary block such as nerve injury and local anaesthetic toxicity. Hospital discharge may also be delayed due to reduced mobility or dexterity. A wrong-sided nerve block may lead the team to continue to wrong-site surgery1.

Literature suggests common factors involved in wrong-sided blocks include time pressure, distraction, fatigue, cognitive overload, new personnel, bilateral pathology, lack of a visible surgical site mark and a time delay between the World Health Organisation (WHO) Safety Checklist sign-in (or equivalent) and performance of the nerve block. Other factors include turning the patient during which left and right sides can become confused and use of abbreviations on documentation2.

Unambiguous documentation and clear processes to enhance communication are essential.

Resources

Related links

  1. NHS, Safe Anaesthesia Liaison Group, Stop Before You Block
  2. Australian and New Zealand College of Anaesthetists, Stop before you block guide.
  3. NHS, Royal College of Anaesthetists, Safe Anesthesia Liaison Group (2021), Stop Before You Block <SALG | Stop Before You Block.
  4. ACORN Journal of Perioperative Nursing (2019), Creating and applying shared mental models in operating room.
  5. The Royal College of Anaesthetists, Stop before you Block campaign
  6. Sage Journal (2016), Slocombe P, Pattullo, Audit: A site check prior to regional anaesthesia to prevent wrong-sided blocks.
  7. Hussien E, Chuter E, Haslam N. New Prep, Stop, Block guidance for blocks close to the midline. Anaesth Rep. 2022 Oct 14;10(2):e12186. doi: 10.1002/anr3.12186. PMID: 36275394; PMCID: PMC9581588.
Last updated: 11 July 2024