Fascia-Iliaca Block – Dr Liz Wyatt
remember your anatomy! use anatomical landmarks then confirm with US…identify vessels, move laterally, identify iliacus muscle and position needle deep to fascia lata
volume is the key! Ropicavaine 1-3mg/kg diluted to 40ml with N/Saline
document local anaesthetic, dose and time in notes and on medication chart
see Liz’s presentation here
Pneumothorax – Dr SzeChi Freidanck
British Thoracic Society Guidelines – small < 2cm at hilum
Western Health Respiratory and Thoracics Units Guidelines:
1) Large pneumothorax which is chosen to be treated conservatively (asymptomatic patient) and for primary VATS must be discussed with the Thoracic Registrar/Consultant and booked into their clinic for review in 1 week
2) Conservative treatment (small/moderate) asymptomatic : a period of observation in EOU then followed by repeat X-ray prior to D/C is a safe plan: Respiratory Clinic follow up
3) Symptomatic patients should have an intervention: small bore catheters/Pig tail catheters: acceptable choice
4) Complications following intervention should be looked for :bleeding/catheter blockage, and transfer patients are at risk of complications (Footscray remains the preferred destination for any patient with ICC/catheter)
5) Complete/Total lung collapse/Radiological signs of Tension Pneumothorax = prompt intervention= ICC