Regional Anaesthesia & Local Anaesthetic Infusion Delivery:

Clinical Situations LA Delivery Strategy Status Connector Comment
Chest Wall Trauma

(Fascial Plane Blocks, PVBs & Epidurals)		 1. Epidural / LA Pump 1st line Luer lock
(Non-NRFIT / Standard)		 High clinical priority in terms of pump usage ie pumps should be prioritised for these cases
Drugs: Levobupivicaine 0.125% (we have plentiful stocks of this).
EPMA: Continuous Infusion
2. Hand Bolus 2nd line Luer Lock
(Non-NRFIT / Standard)		 Option of last resort
Not sustainable at scale
Will need ongoing review; if it becomes a significant workload will need assessment of ability to support this
Amputations

(Peripheral Nerve Catheters)		 1. Epidural / LA Pump 1st line Leur Lock
(Non-NRFIT / Standard)		 High clinical priority in terms of pump usage ie pumps should be prioritised for these cases
Drugs: Levobupivicaine 0.125% (we have plentiful stocks of this)
EPMA: Continuous Infusion
2. Hand Bolus 2nd line Leur Lock
(Non-NRFIT / Standard)		 Option of last resort
Not sustainable at scale
Will need ongoing review; if it becomes a significant workload will need assessment of ability to support this
Rectus Sheath


(Elective Patients)		 1. Hand Bolus (ACCU / 3F) 1st line NRFIT Currently hand boluses will be delivered by the ACCU/3F team; Catheters to be removed when patient goes to the ward
Drugs: Levobupivicaine 0.125% (we have plentiful stocks of this)
2. Hand Bolus (Wards) N/A We do not have the resource to support this
Rectus Sheath

(Emergency Patients)		 1. Hand Bolus (ACCU) 1st Line NRFIT Currently hand boluses will be delivered by the ACCU team; Catheters to be removed when patient goes to the ward
Drugs: Levobupivicaine 0.125% (we have plentiful stocks of this)
2. Hand Bolus (Wards) N/A We do not have the resource to support this
Peripheral Nerve Catheters

(Non-Amputation Patients)		 1. Epidural Pump N/A We do not have the resource to support this (pumps)
2. Hand Bolus N/A We do not have the resource to support this (anaesthetists)

Epidurals