PS27 2013: Local anaesthesia

 

List:

·        Relevance

·        Risks

·        Responsibilities

 

Relevance:

·        Minor surgery

·        Minor dentistry

 

Risks:

Local anaesthetic

·      LAST

·      Localised neurotoxicity

·      Allergy/anaphylaxis

Vasoactive

·      Hypertension

·      Tachycardia

·      Arrhythmia

Needle

·      Pain

·      Damage

 

Responsibilities:

Education and training

·      Anatomy

·      LA pharmacology

·      BLS (essential)

Pre-op consult

·      Pre-assessment (Hx/Ex/Ex. LA safe? Sedation required?)

·      Provide information

·      Obtain informed consent

Anticipate disaster

·      Location suitable for BLS

·      Means of calling for help

·      Oxygen, bag + mask

Technique

·      Give minimum necessary dose

·      Do not exceed safe dose

Monitoring

·      Observation: A, B, C, D

·      +/- Objective monitors (esp NIBP)

·      +/- Assistant

Recovery

·      Consider need for observation

·      Consider need for pain relief

·      Instructions for care of operative site, activities

Documentation

·      Pre-op consult

·      LA injection

·      Procedure

·      Monitoring

·      Complications

 

 

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