An audit is being conducted of regional blockade procedures performed in orthopaedic theatres to understand current limitations. Anesthetists are asked to complete a form after ensuring the patient is stable, indicating whether a block was performed and the reasons for any decisions not to perform one. The form collects data on patients receiving upper or lower limb surgery and the type of block or reasons for not providing one. It seeks to audit the number and attitudes towards regional blocks in orthopaedic settings.

1. An AUDIT OF the limitations to performance of
REGIONAL BLOCKade in orthopaedic theatres
An audit of the regional procedures is being conducted in the orthopaedic
theatres. In order to understand what limitations are currently faced it would be
appreciated if this form could be completed once you have ensured that the
patient is safely anaesthetized and stable.
Please note the following:
The completion of forms is to be done for patients only receiving limb
surgery ( upper or lower)
For any procedure -regional or central neuraxial block- with or without a
general anaesthetic (see normal regional exclusion criteria below).
Below is space for details to be entered if a block was or wasn’t
performed and the reasons why.
(This is an audit of the number of regional blocks we are doing in orthopaedic
theatre and the attitudes and obstacles we may have against doing these blocks.
The study is only being run on patients receiving limb surgery (either upper or
lower limb).
If there is any patient who could possibly receive a regional or central neuraxial
block they will qualify for the study (see normal regional exclusion criteria
below)
We would be grateful if you could fill out this form once you have ensured the
patient is safely anaesthetized and stable.
We have allowed for you to fill in the details of your block if you have done one
and if you have not there is space for you to justify why not.)
PATIENT DATA
Age
Gender
F M
Procedure
ASA
I II II IV V E
ANAESTHETIST DATA

2. Senior Consultant Junior consultant Registrar Medical officer
Number of years experience
<3 3-6 6-15 >15
Have you done a course in (mark multiple if the case)
Ultra sound Nerve stimulation Landmark techniques
If you did a regional/neuraxial block please answer section ……………A
If you decided to not perform the block please answer section………...B
SECTION A
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Type of Block
Upper limb
Interscalene Supraclavicular Axillary Wrist Digital
Other – please specify
Lower Limb
Femoral Sciatic Popliteal Ankle Local
infiltration
Digital
Other – please specify
Neuroaxial- not sure if we need these subsections- maybe – just spinal/
epidural / combined CSE
Spinal plain
Bupivacaine
Spinal heavy
Bupivacaine
Spinal with
Maciane and
Morphine
Epidural
Technique
Ultrasound Nerve stimulator Landmark
Type of Local anaesthetic

3. Bupivacaine 0,25% Bupivacaine 0,5% Other……………….
Complications
Pain on injection Blood aspirated Poor block/failed LA toxicity
none
SECTION B
In the 1-5 scale, please indicate how much each of these criteria affected your
decision not to do the block
1 for not at all a problem
3 for the fact that this obstacle existed but it was not a major factor
5 for being one of the main factors for not performing the block
Patient refusal
Yes No
Contraindications
Site Sepsis Coagulopathy
Plt < 90
Preexisting
neurological
fallout
Risk of
Compartment
syndrome
other
Time constraints- rather yes/ no
1 2 3 4 5
Resources unavailable yes/no
1 2 3 4 5
No nursing staff available to assist yes/ no
1 2 3 4 5
Unfamiliar with technique yes/no

4. Lack of supervision/ guidance
1 2 3 4 5
Orthopaedic preference against performing the block yes/ no
1 2 3 4 5
Nursing staff pressure against doing the block (not sure about this?- this is same
as no staff rather)
1 2 3 4 5