361 Is Adrenaline Safe for Use in Digital Blocks? Changing Departmental Perceptions

Aim We aimed to improve the understanding and perception of safe local anaesthetics with adrenaline injection in fingers among a cohort of registrars and consultants. Method Guided by the Plan-Do-Study-Act framework, we designed a survey looking at the key aspects of safe administration of adrenaline in fingers i.e., dose, mechanism of action, administration and toxicity. We collected data from registrars and consultants within the T&O team, developed and implemented evidenced based teaching at a local meeting within the hospital department. We repeated the survey following the intervention to assess changes in understanding and perception of adrenaline injection in fingers. Results The number of surgeons involved in two phrases were 13 and 11. Only 38% of the surgeons would consider injecting local anaesthetics with adrenaline into digits before the intervention. Understanding of safe adrenaline injection in fingers before the intervention was generally suboptimal. 64% correctly identified the safe maximum dose of adrenaline with local anaesthetics injection. 46% and 23% were able to identify the mechanism of actions and optimal time of haemostatic effect. The majority (92%) identified phentolamine as an agent to reverse the effect of adrenaline. Following the intervention, understanding of the 4 areas have significantly improved to 82%, 64%, 64% and 100% respectively. Perception of adrenaline injection in fingers has also shifted. 91% of registrars and consultants would use adrenaline with local anaesthetics in fingers injection. Conclusions This intervention effectively improves surgeons’ understanding and therefore the likelihood of using this safe technique in the selected group of patients’ cohorts.