Pitfalls

Timing

Too soon or too late?

It is tempting to start a procedure immediately after the local anaesthetic. Remember that all anaesthetics take time to work and give them that time.

Alternatively, it is possible that you will be called away after putting a ring block in, and by the time you return it is wearing off.

Too much

Try not to have more anaesthetic on the trolley than can safely be given at one time.

Sometimes, you will run out, and it’s very tempting to ask for another ampoule.

Try and work out what you need before you start and choose the drug and concentration well.

If you have to use more, you will need to wait before giving it.

Lie them down

Patients keel over regularly when having procedures performed – the bigger they are, the harder they fall.

Get into the habit of lying patients down wherever possible.

Adrenaline

Adrenaline is underused. It helps stop bleeding, creates a bloodless field (good for foreign body removal) and prolongs anaesthetic action. Why not use it more?

‘Brutacaine’

With the range of agents available, and the possibility of sedation or general anaesthetic, it is rarely, if ever, necessary to resort to physical restraint.

Be accessible

Suturing in a cubby-hole at the end of the corridor may seem like a good use of space and you might not be disturbed (or missed). But when a patient collapses, you are out on a limb, so make sure you undertake procedures where you are always able to call for help.

Learning bite

Correct technique will minimise complications.