Anaesthetists Handbook - MEDICAL EDUCATION at University ...

Miscellaneous issuesCentral neuraxial blocksYou must not use open vessels of antiseptic skin preparation agentson your sterile trolley. There is a risk of splash contamination ofneedles.The department recommends the use of 0.5% chlorhexidine inalcohol (e.g. Hydrex) sprayed to the skin and allowed to dry. TheODP will spray the skin on request.2% chlorhexidine gluconate in 70% isopropyl alcohol (ChloraPrep) isindicated for CVP catheters and dressing changes only; do not use itfor central neuraxial blocks.Inotrope infusions[Dr Glynn Evans, February 2007; appraised by Dr Edwin Borman, January2010]Patients who are hypotensive in recovery sometimes can benefit frominotrope or vasoconstrictor infusions such as metaraminol ornoradrenaline (norepinephrine), even without invasivehaemodynamic monitoring. It is inappropriate to return such patientsto their normal ward while such infusions are in progress. Insteaddiscuss the patient’s needs with a supervising consultant andconsider the need for critical care.Intravenous cannulas[Dr Edwin Borman, January 2010]Safety cannulas are to be used in all clinical areas. They are beingintroduced over the period of January to March 2010. This is a healthand safety measure designed to help to reduce the number ofneedle-stick injuries.The technique for these cannulas is slightly different to that fortraditional cannulas and you will need to take care if using them forthe first time.Anaesthetists Handbook January 2010 205