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Anesthesiologist-led protocols and wrong-sided blocks

Sep 10, 2016 | Surgical Errors

New York patients who undergo nerve blocks in connection with a surgical procedure may be interested in knowing more about the implementation of an anesthesiologist-led protocol that could prevent a wrong-sided block from occurring. Though not as catastrophic as wrong-sided surgery, complications can sometimes be connected with the administration of a nerve block, which is also an invasive procedure.

According to an article published in Anesthesiology News on Sept. 6, wrong-sided blocks occur but go unreported at many institutions that have a zero-tolerance policy for this particular type of anesthesiology error. In the article, a near-miss that occurred at Duke University Medical Center is presented that illustrates how such medical accidents could be prevented when an anesthesiologist-led block protocol is successfully implemented.

In the particular case cited, a limb was marked for a unilateral procedure in accordance with institutional guidelines. Per protocol, the surgeon initialed a spot on the inside of the knee where a single-shot sciatic nerve block was to be administered, but when the patient’s knees came together during further preparation for surgery, sweat from the body caused a mirror image of the mark to also become imprinted on the opposite knee.

Although a contralateral mark such as this could potentially lead to a surgical error, a newly-implemented protocol helped ensure that this did not happen in this particular situation. As discussed at the 2016 annual meeting of the American Society of Regional Anesthesia and Pain Medicine by a physician on the surgical team, a precautionary procedure had been instituted that required the anesthesiologist to make a separate initial at the site where the needle would be inserted into the patient’s skin, ensuring that the block would be performed on the correct side.

Although this procedure ran smoothly, such fail-safe protocols may not always be in place. Patients who have been injured in a surgical procedure due to negligence on the part of a practitioner may want to meed with a medical malpractice attorney to see what recourse for obtaining appropriate compensation may be available.