p23

P23

THE INTRODUCTION OF A SONOCLUB: IMPROVING REGIONAL ANAESTHETIC KNOWLEDGE AND SKILLS FOR TRAINEES AND CONSULTANTS AT A TERTIARY PAEDIATRIC CENTRE

C. Stevens, A. Chauhan, A. Selman, S. Greenaway, J. Hammerschlag

Evelina Children's Hosptial, London, UK

Introduction

A recent editorial by Turbitt et al. suggests that the growing number and complexity of regional anaesthetic blocks performed under ultrasound is both unnecessary and lacks sufficient evidence to support their use. This is likely to intimidate and deter general anaesthetists from delivering regional anaesthesia (1).  They suggest that all anaesthetists should be trained in a limited number of evidence-based ‘Plan A Blocks.’  This has been further adapted for paediatric anaesthetic practice by Pearson et al. (2).

We designed and delivered a regional anaesthesia ‘Sonoclub’ at Evelina London Children’s Hospital (ELCH), aiming to improve competence and confidence of trainees and consultants in performing the paediatric ‘Plan A’ blocks. As one of the leading paediatric hospitals, it is important for us to offer the best anaesthetic and analgesic options to patients undergoing surgery.

Methods

We identified paediatric anaesthetists within our department who regularly perform regional blocks and formed a teaching faculty from this group. We planned and delivered a series of teaching sessions which we called ‘Sonoclub,’ based on the suggested ‘Plan A’ blocks by Pearson et. al.

Each session had a standardised format: a short lecture comprising the anatomy, indications, pitfalls and technique for performing each block, and a review of equipment and drug dosing. This was followed by hands-on practice using ultrasound on volunteer models.

Each 90 minutes session was open to all trainees and consultants. We planned some sessions within working hours and some after, so that everyone had the opportunity to attend.

The effectiveness of the teaching was assessed using feedback forms before and after each session.

Results

A range of trainees attended, from core trainees to senior registrars and clinical fellows. The sessions were well received and feedback rated highly, with an average score of 8.6 out of 10. There was a mean improvement of 20% in attendees’ confidence levels of performing the blocks after each session.

Discussion

We demonstrated that attendees felt more competent and confident in delivering regional anaesthesia in children, and are now more likely to use these techniques in daily practice.

Some of the challenges identified when using this model were a lack of time to attend due to pressures of clinical work, the need for regular supervised clinical practice to consolidate knowledge, and access to teaching space and ultrasound machines to deliver the sessions.

We will continue the sessions, developing them as an established educational resource within our department. We have put laminated copies of the ‘Plan A Blocks’ poster in each theatre as a quick reference guide, and to prompt anaesthetists to use these blocks where appropriate. Additionally, following feedback, we plan to include point-of-care ultrasound teaching in collaboration with our paediatric intensive care colleagues.

References:

  1. Future directions in regional anaesthesia: not just for the cognoscenti L.R.Turbitt et al. Anaesthesia 2020, 75, 293–297.
  2. New blocks on the kids: core basic nerve blocks in paediatric anaesthesia. Anaesthesia 2023, 78, 3-8.

 

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