Table 7.

Nudgets for Rapid Spinal Anaesthesia

1. Standby experienced anaesthetists in labour ward theatre

2. Standby spinal pack in labour ward theatre

3. Pre-loading or co-loading is required with constituted ephedrine on standby

4. Intravenous line put in place in labour ward by obstetrician

5. No touch technique. Scrub and glove rapidly

6. Local infiltration is optional but helpful

7. One touch technique. Once the spinal needle has pierced the skin it must not be withdrawn until CSF is seen and drug is deposited. Difficulty in getting it may allow for the second touch

8. In the absence of loading, 5mg of ephedrine i.v is given prophylactically to prevent precipitous drop in blood pressure

9. Surgery starts almost immediately