Epidural analgesia is an established method of post-operative analgesia across the Trust. It is normally delivered using a patient controlled epidural analgesia (PCEA) system which enables the patient to give themselves a bolus (under predefined parameters) in addition to the background infusion. Patients with epidural analgesia are nursed on the St Peter’s Hospital site in the Post Anaesthetic Recovery Unit (PACU), Intensive Care Unit (ICU), Surgical Dependency Unit (SDU), the Medical High Dependency Unit (MHDU), and the Surgical Wards. Nursing staff working in these areas receive training, are competent to care for patients with epidurals and are encouraged to pass the epidural competency The orthopaedic ward rarely has patients requiring epidural analgesia and as such the staff are no longer competent to care for these patients. Ideally they should be cared for in an area where staff are competent. Advice from the Inpatient Pain Service should be sought on a case by case basis.
Maternity also provide an epidural service using the same pumps but work from their own policies and are therefore not included in this policy. The protocols on the pumps in Maternity are significantly different from those used for acute pain management and are therefore not interchangeable between these two areas.
Patients from the above areas who are receiving epidural analgesia may occasionally need to be transferred to Coronary Care Unit (BACU). The patient may be managed on BACU with the epidural but must not be moved to a medical ward whilst receiving epidural analgesia
There is no post-operative epidural infusion service at Ashford Hospital as there is no longer an anaesthetist on site 24 hours a day and the infrequency of this mode of analgesia being used. Epidural injections are still carried out as a stand-alone procedure for chronic pain and are not covered by this policy
Epidural analgesia is only to be administered using a yellow Smiths Medical CADD Solis pump and a dedicated yellow stripped administration set. This equipment is not to be used for any other infusions. No other equipment should be used to administer epidural infusions.
The purpose of this policy is to outline the expected care of the patient receiving epidural analgesia. This will assist staff to manage and care for these patients appropriately and safely.
|Compiled by:||Harriet Barker, Lead Nurse Pain Service|
|Ratified by:||Drugs and Therapeutics Committee|
|Date Ratified:||November 2017|
|Date Issued:||December 2017|
|Review Date:||November 2020|
|Target Audience:||All clinical staff caring for patients with epidural analgesia|
|Contact name:||Harriet Barker, Lead Nurse Pain Service|
- Administration of Injectable Medicines via Intravenous Route Policy & Procedures
- Trust Medicine Management Policy
- Epidural Competency
- Trust Epidural Analgesia Observation Chart
- Patient Information Leaflet: Epidural Haematoma Letter
- Trust Oxygen Policy