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Pre-amble |
· Indications · Contraindications: o
Haem: plt >50 if normal, >?70 ?80 if PET o Cardiac: fixed output lesion o Neuro: Arnold-Chiari malformation, SOL with ↑ICP o MSK: spine surgery · Expectations: analgesia, immobility, IDC · Risks: unilateral 1/20, failure 1/50, PDPH 1/100, mild neuro 1/5K, severe neuro 1/250K |
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Preparation |
· IV access · CSL 500mL · Monitoring: NIBP and SpO2 · Assistant: trained midwife |
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Performance |
· Position: sitting · Asepsis: patient and self · Needling: LORS, feed catheter, falling meniscus, no blood or CSF · Securement: tegaderm + mefix · Dose: 75mcg fentanyl + 3 x 5mL 0.1% ropiv q5 mins |
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Post-procedure |
· Infusate: 0.1% ropiv + 2mcg/mL fentanyl · Pump: 5mL q1h REGULAR + 10mL q15mins PCEA · Monitoring: vitals + neuro + CTG · Follow up: explain red flags + APS review or phone number |
SOAP Consensus Statement Thrombocytopenia 2021.pdf
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