Unit 8b
Obstetric Anaesthesia
WORKSHEET

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Question: 
How and what would you prepare differently for an obstetric patients undergoing a spinal anaesthetic? 

Checklist:
What equipment would you have available for an anticipated difficult airway...?
Make a list of equipment and provide a rationale for having it available.
Equipment 	Rationale	

		

		

		

		

		

		

		

		

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Stop and Think: 
Why are obstetric patients usually positioned supine with the table tilted to the left or a wedge under their right flank? 

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Stop and Think: 
From this list consider...
•	Do you know where all the equipment is kept?
•	How to prepare it?
•	How to use it?
•	Who has responsibility for checking it daily?
•	How is this documented?

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Stop and Think: 
At what point would you ask for help if assisting with an intubation? 
After the 1st attempt at intubation, 2nd...3rd... Or would you wait to be asked to get help?

Stop and Think: 
As an anaesthetic practitioner have you made yourself familiar with the Difficult Airway Society (DAS) protocols? 
It must be highlighted that these protocols are not specific to the obstetric patient - why do you think this may be? There are currently no national guidelines specific to obstetric patients...

 

Stop and Think: 
What other considerations are there when positioning the patient on the operating table?

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Stop and Think: 
What DVT prophylaxis is utilised in your area?

Question: 
Do you think there is a time when the team would proceed if it were in failed intubation scenario?

 

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Stop and Think: 
In your clinical area do you undertake obstetric failed intubation drills or do you have an algorithm to follow?

Question: 
Wake up or proceed..?
This is a question that should have been considered prior to induction...

 

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Stop and Think:
Do you know where the blood is kept and how to obtain this in an emergency situation both in and out of hours?

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Stop and Think:
Are you aware of the role, responsibilities and limitations of Assistant Practitioners in the obstetric theatre?

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